Introduction

In today’s rapidly changing world, where technology and digital devices have become an integral part of our lives, assessing and protecting children’s vision is crucial. With the rise in the prevalence of myopia, also known as near-sightedness, regular eye examinations for children have become more critical than ever. This blog will shed light on the significance of children’s eye examinations, emphasising the importance of being outside and minimising screen time.

Our child’s eyes are unique. In the early years, vision helps them discover the world around them, their home, and you. Later, as they go through school, their eyesight lets them learn and discover; about 80% of what is taught in schools is presented visually. Being able to see is incredibly important in your child’s overall development.

We would like to acknowledge and thank Nicola Bennett, our Head of Clinical Education, who wrote the sections on ‘Typical children’s eye conditions’ and ‘What happens in a children’s eye test’, and checked the redaction, of this article.

The importance of eye examinations

Regular eye examinations for children play a crucial role in their overall well-being. When it comes to your child’s eye health, their first eye test is vital. While routine developmental checks assess their eyesight, they may not be as comprehensive as an eye test conducted by a qualified optician. That’s why we strongly recommend scheduling an eye test for your child from an early age.

Here are some key reasons why these examinations should not be neglected:

Early detection of vision problems

Regular eye examinations can help identify and address potential vision problems early, minimising their impact on a child’s development. Children may not always be able to communicate vision issues, affecting their daily activities and educational performance. Conditions like squinting and amblyopia (lazy eye) can be treated more effectively when identified earlier. This early detection can make a tremendous difference in your child’s life.

Preventing the progression of myopia

Myopia has become increasingly prevalent among children, and its severity can worsen over time if not appropriately managed. Regular eye examinations can help monitor the progression of myopia and enable the eye care professional to recommend interventions, such as specialised lenses or contact lenses, to slow down its progression.

Enabling a happy and fulfilling school life

Getting eyes tested before your child enters full-time education allows for the early identification of any potential problems. Addressing these issues early on sets your child up for a happy and fulfilling school life.

By prioritising your child’s first eye test, you are taking an essential step towards safeguarding their vision and helping them thrive academically and socially. Please schedule an appointment with a qualified optician to give your child the best start regarding their eye health.

When should children have their eyes tested?

Children should have their first visit to the optician at different ages, depending on their circumstances. Tests are available for infants and preschool children who cannot read, recognise letters, or speak. If you have any concerns about your child’s eyesight, you should find a local optician who can perform vision tests on them.

Even if your child’s vision appears to be good, it is still important to schedule a full eye test with a qualified optician when they reach school age. This is to ensure that there are no underlying vision issues that could potentially impact their early school years. You can find a suitable optician near you to schedule an appointment.

Signs your child needs an eye test

Determining if your child has vision issues can be challenging, so regular eye tests are crucial. It is important to get your child’s vision checked if there is any family history of childhood eye health but also if you notice any of the following signs.

Several signs might indicate the need for an eye test:

• Family history of childhood eye problems
• Straining their eyes or tilting their head to see better
• Frequent eye rubbing
• Losing their place while reading
• Sensitivity to light and excessive tearing
• Falling behind in school
• Complaints of headaches or tired eyes
• Presence of a ‘turn’ in the eye or misdirection of the eyes
• Consistently sitting too close to the TV or holding a book too close
• Avoidance of activities requiring near vision (e.g., reading, homework) or distance vision (e.g., sports)
• Closing one eye to read, watch TV, or see better
• Avoidance of using a computer or tablet due to eye discomfort
• Seeing a ‘white reflex’ in photographs (similar to red-eye but appearing white). This would require a check promptly as it could require urgent medical attention.

If you observe any of these signs in your child, it is advisable to seek an eye examination from a qualified optician. Early detection and intervention can significantly benefit your child’s visual health and overall well-being. Don’t hesitate to schedule an appointment if you have concerns.

Typical children’s eye conditions

Refractive errors

Nearsightedness, farsightedness, and astigmatism are common refractive errors that can affect your child’s ability to see clearly at various distances. Correcting these issues with glasses or contact lenses can dramatically improve their quality of life.

Amblyopia (lazy eye)

This condition occurs when one eye is weaker than the other, leading the brain to favor the stronger eye. Early detection and treatment, often involving patching the stronger eye, can prevent long-term vision problems.

Strabismus (crossed eyes)

Strabismus is a misalignment of the eyes that can lead to double vision and poor depth perception. Timely intervention, such as glasses, eye exercises, or surgery, can correct this condition.

Binocular vision problems

Children need both eyes to work together efficiently for optimal depth perception and coordinated movement. Binocular vision issues can lead to eye strain and difficulty reading.

Eye health

Regular eye tests also help identify potential eye diseases or conditions like allergies, infections, or even more serious issues like glaucoma.

What happens in a children’s eye test

 During your child’s sight test, several different tests will be carried out by a qualified optician. This will help to determine your child’s eye health as well as detection of any visual problems they may have and if there are any glasses required.

The eye care professional will start by discussing your child’s medical history, any previous vision concerns, and the child’s daily activities. You might be asked about any noticeable behaviors or symptoms related to the child’s eyes.

Some of the tests your child may have been listed below;

Red reflex test

The red reflex test is usually carried out alongside a general examination of your baby’s eyes, as part of newborn checks however can be used in a sight test too. It involves a handheld instrument called an ophthalmoscope that magnifies the eyes and uses light so they can be examined clearly.

Pupil reflex test 

The pupil reflex test involves shining a light into each of your child’s eyes to check how their pupils (black dots at the centre of the eyes) react to light.

Visual acuity test

This assesses your child’s ability to see clearly at various distances using a Snellen or logMAR chart or other age-appropriate visual tests. Your child will be asked to read letters or identify shapes to determine their visual acuity. This helps identify nearsightedness, farsightedness, or astigmatism.

Refraction test

A refraction test is performed to determine the exact prescription needed for corrective lenses. This involves your child looking through a series of lenses and indicating which ones provide clearer vision.

Eye alignment and movement assessment

The optometrist will check for any misalignment or coordination issues between the child’s eyes. This can help identify conditions like strabismus (crossed eyes) or amblyopia (lazy eye).

Binocular vision assessment

This test examines how well your child’s eyes work together to provide depth perception and accurate coordination. Any issues in binocular vision can lead to difficulties in activities like reading and sports.

Pupil and external eye examination

The doctor will examine your child’s pupils for their response to light and check for any abnormalities in the external structures of the eyes, including eyelids, lashes, and tear ducts.

Retinal examination

Depending on your child’s age and cooperation, they may have a retinal examination using specialised equipment. This allows them to evaluate the health of the retina, optic nerve, and blood vessels at the back of the eye.

Eye health evaluation

This will assess the overall health of the child’s eyes, checking for any signs of infections, allergies, or other eye diseases. Early detection of eye health issues is crucial for timely intervention.

The optometrist will use many different pieces of equipment during the Sight Test and will explain to both you and your child what each piece is used for.

The role of outdoor activities

Besides eye examinations, encouraging children to spend time outdoors helps reduce the risk of the onset of myopia.

Here’s why being outside is essential for children’s eye health:

Exposure to natural light

Natural light is crucial for developing and protecting healthy eyes. Being outdoors exposes children to adequate levels of natural light, which helps regulate eye growth and prevent myopia.

Increased distance vision

Outdoor activities often involve looking at objects in the distance, which can help reduce eye strain associated with prolonged near-work. This helps in reducing the progression of myopia.

Physical activity

Outdoor activities also promote physical activity, which is essential for overall health. Regular exercise not only benefits the body but also positively impacts eye health.

Minimising screen time

Excessive screen time has become a concern, especially for children’s eye health.

In the UK, children aged between 5-16 years spend an average of 2-3 hours per day watching television, 1-3 hours on the internet, 1-2 hours playing video games, and over an hour on mobile phones (not talk), a total of 6.3 hours of screen time per day.

According to parental control software company, Qustodio, social media app usage has increased by 130% amongst children in the UK since the beginning of the pandemic.

A Canadian study that examined children’s physical activity, outdoor time, screen time, and social media use during the COVID lockdown in early 2020 found that 8-year-olds spent an average of more than five hours a day on screens for leisure, in addition to screen time needed for schoolwork.

Here’s why it is crucial to reduce screen time:

Digital eye strain

The prolonged use of digital screens can lead to digital eye strain, which includes eye discomfort, headaches, sore or tired eyes, difficulty focusing, dry eyes, blurred or double vision, and increased sensitivity to light. Regular breaks and limited screen time can help mitigate these issues.

Increased risk of myopia

Research suggests a correlation between increased screen time and myopia development in children. By reducing screen time, we can reduce the risk of myopia progression.

Blue light

Although no definitive research shows blue light from digital screens harms children’s eyes, it is better to take precautions.

What many people call ‘blue light damage’ is usually just digital eye strain that occurs due to frequent screen use or an underlying small prescription relating to myopia (short-sightedness) or hyperopia (long-sightedness).

Therefore, parents should have their children follow the 20:20:20 rule (it means your child should look away from their screen every 20 minutes and look at something 20 feet away for at least 20 seconds. If you encourage your child to follow this rule it will relax their eye muscles and help to reduce the risk of many symptoms of digital eye strain).

Other tips include adjusting screen positioning, scheduling outside time, staying hydrated, and establishing media-free times.

In summary, regular eye examinations for children are crucial in protecting their vision and ensuring their overall well-being, especially in this age of increased screen time and the prevalence of myopia. Additionally, encouraging children to spend time outdoors and reducing screen time can further contribute to preserving their eye health. By prioritising children’s eye examinations and adopting healthy lifestyle habits, we can safeguard their vision and empower them to thrive.