Easy Steps to Strong Child Vision

(The goal of VisionMechanic.net is to provide science-based clinically relevant resources about humans, for humans. All humans. This series highlighting International Vision and Learning Month (August) is more focused on those humans who are in formal learning programs, most notably, younger humans. If you yourself are a learner, or if you teach them, guide them, care for them or provide therapy for them, then this series will be of interest to you.)

This article details some basic steps to take to correct the most common problems with vision. Even if you feel your child / patient / student is unaffected by vision problems, until you can check off a list of ‘knowns’, you simply don’t know and are subjecting the child to unnecessary risks. A further post will consider what else can be done to ensure children with Visual Impediments to Learning and Development (VILD) can make an attempt at life and learning on a level playing field, visually speaking.

While the picture is somewhat more complicated than this, this series on Vision and Learning is designed to highlight core principles of how vision works, and to also underline how we ignore vision and the costs associate with this. If you’re serious about vision, and if you care for children you should be, the Vision and Learning series will get you started with the key pieces to protect what is important and to avoid common pitfalls.

Even if you feel your child / patient / student is unaffected by vision problems, until you can check off a list of ‘knowns’, you simply don’t know and are subjecting the child to unnecessary risks.

The following list of steps to be taken is adapted from the paper ‘Visual Impediments to Learning‘ which offers much more detail regarding how vision impacts on child performance and health. Don’t forget this entire series is also devoted to exploring these topics.

  1. All children need an eye exam. Start there.
    • Read this before you begin so you know what to look for – not all ‘eye tests’ are going to uncover all Visual Impediments to Learning and Development.
    • Read this to know whom to see. If you need a general comprehensive eye exam, a surgeon is not the one to see.
    • Exams for children are covered under most health systems and plans.
  2. Be sure to review the notes that follow to have a baseline for understanding.
  3. At the exam, ask for an explanation of the status of eye movements:
    • Saccades (jump eye movements).
    • Pursuits (smooth eye movements).
    • Vergence (moving eyes inward and outward in a coordinated fashion).
    • Fixation (holding both eyes steady on a target at 40cm).
    • Any restrictions or limitations can and should be addressed through physical/visual training. This is a complex topic covered in other posts in visionmechanic.net and drboulet.com among others.
  4. Ask for a copy of the glasses/optical prescription. All children/people have such a measurement – it’s the optical calculation or recipe to make distant light rays focus on the retinas with zero effort. Everybody has something, and it’s important to know what the values are in every case, period. As a general rule (must be assessed individually depending on circumstances and visual tasking requirements):
    • Myopia / Nearsightedness: This is expressed as a ‘minus’ prescription with minifying, diverging lenses. Myopia up to -2.50D can be helpful for near work and so glasses are often discouraged if the child is comfortable working without. Myopia of -0.50D or more should be compensated for during distance viewing activities. Myopia should be closely monitored in growing children.
    • Hyperopia / Farsightedness: Hyperopic prescriptions are ‘plus’ prescriptions with magnifying, converging lenses. Children with hyperopia less than +1.75 don’t need compensation for most activities – and can simply be monitored during near tasking for fatigue and other signs of frustration or headache. At +1.50 and above, a reading lens is recommended for digital platforms in particular where text is emphasized. At +2.00 and above, a full time lens is recommended and will be appreciated.
    • Astigmatism: As a rule, astigmatism of more than 0.75D should be compensated for anyone managing any text-based tasking. Engineers and accountants will appreciate the difference this low-level compensation provides. Children with astigmatism over 1.00D should wear compensating lenses most of the time while awake to prevent headache, fatigue, irritability, reading concerns. Uncompensated astigmatism over 1.50 will lead to depressed vision, even blindness (amblyopia).
  5. For the long hours of near-digital learning strain imposed by COVID-related instructional design changes, a ‘low plus‘ approach is recommended for any child needing to work in front of the computer. The same applies to adults: We are, on average, most comfortable gazing off to a distant target, eyes relaxed, and a low plus prescription achieves this same result. What low plus means to any individual will vary, but the same result is achieved by relaxing the focusing and targeting systems for near work. Your optometrist will help you with the math, but it’s pretty straightforward. ‘Plus’ of anywhere from +0.50 to +1.50 can offer any one (under 40) a great boost for extended and comfortable near work.
  6. DO NOT SUBJECT A CHILD TO PSYCHO-EDUCATIONAL TESTING prior to assessment of visual status and before problems identified have been addressed.
  7. Filters: Filters and overlays will have limited impact on reading. For the most part, children who struggle with reading will have other identifiable visual impediments.
  8. Blue Light: Do not worry about filtering out blue light from computer screens. In fact, encourage plenty of blue light exposure through outdoor exploration and play.
  9. Exercise and Play: Active movement, including guided targeting with fingers and hands improves fine visual targeting. Work also major body muscle systems and balance through activities such as swimming, climbing, yoga, and martial arts.

Following the above steps will cost next to nothing to do and save most cases from falling through the cracks. Educators, doctors, psychologists all need to spend more time in reviewing core concepts so that they might better understand how to address problem behaviours related to vision, but more importantly, how to guide parens in preventing these entirely.

In an upcoming post we’ll identify some of the gaps in the system whereby, for some reason, most kids who need the help keep falling through – and how the current COVID-19 environment is making things worse. Simple solutions will be recommended, cost-effective solutions, to help prevent needless suffering and waste of tax-payer dollars.

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