Recommendations for healthy young eyes

Recently a concerned school teacher asked me for help. She is noticing changes in work habits of her Year 7 students, aged 11-12. What was our advice and recommendations regarding device use and working habits?

As optometrists we look for clinical guidelines and studies, to give evidence and support to any recommendations. After 4 days in Tokyo at the International Myopia Congress I have met and heard many of the people who are researching and following young people’s eyesight. But clinical studies are often slow to produce results, especially in relation to children.

In terms of preventing myopia (short-sightedness) the biggest recommendation is making sure young children have two hours of outdoors time each day. This has been shown to delay the onset of myopia. Rock solid, with loads of clinical evidence to support this advice.

Here are my recommendations:

Not too close. This is a great one to tell children, first punch yourself in the chin, then don’t let your book/phone/screen come closer to your eyes than your elbow.

Regular Breaks - 20/20. After 20 minutes working/looking at close range, take a break, for 20 seconds.

Good posture makes sense. Hold your phone or screen directly in front, not looking sideways for long periods which is work for your eyes to coordinate.

The challenge and concern for most parents is around restricting the amount of time young people spend on screens. For more informative, research and resources, visit the website Screen Sensible Use, put together by Julie Cullen, a parent and physiotherapist. Julie is collating research and encouraging us all to consider the long term impact of our increasingly digitally focused lifestyle on children’s development. She has excellent references. My Kid’s Vision is an informative website about myopia, with a useful tool to calculate risks of children becoming myopic.

Meantime, apply common sense and if you have any concerns about your young person’s eyesight have them tested.

Considering Myopia Profile - are these eyes at risk?

For much of our working careers helping young people who were myopic (short-sighted) was simply a matter of prescribing glasses or contact lenses. Then adjusting the strength of the prescription as eyesight continued to deteriorate through the teenage years.

These days we know so much more about myopia, and how to we can manage myopia to try to slow down the rate of progression.

The best time to start is before eyes have become myopic, when we can identify young eyes at risk.

This tool shows how we evaluate the risk of a child developing myopia.

The good news - we can modify environmental risk factors.

If you have any questions, or would like to know more please get in touch.

What to expect at an eye examination?

If you are coming for your first eye examination what can you expect?

The foundation is your concerns. We would like to hear of any issues you have with your eyes, your vision, or your glasses and any problems you may have had with your eyes in the past, even if it is years ago. This is all useful and important.

Your eyesight will then be measured - “what size letter can you read on the chart”. Next will be a series of questions, “which is better lens 1 or 2”, as we refine and optimize your vision. The end result is a prescription which we can use for any glasses, or simply to compare with your existing pair.

Onto the health checks when we will examine your eyes on the microscope, starting at the front with the lids and eyes surface, moving through to the retina and nerve at the back (read more about what we see inside your eyes.) We will measure the eye pressure with a tonometer. This is important because increasing eye pressure means a greater the risk of getting glaucoma.

Sometimes we will recommend further testing, commonly a peripheral vision screening test. This test shines light in your field of vision where there would be reduced sensitivity in early glaucoma. We often use OCT scans to show a more detailed picture of the retina inside the eye.

With all this information we can help work out the solution for any difficulties you are having. Or simply be able to reassure you that your eyes and vision all look good - which is worth coming in for.

If we are recommending glasses, either first time glasses or a change to your current glasses, we will show you what to expect by mocking up lenses in a trial frame. Our team includes Dispensing Opticians who help with lenses, frames and sunglasses choices.

If you have any questions about having your eyes checked, don’t hesitate to contact us.

Sunglasses competition- November 2019

Print out the entry form below, fill it in and drop it into the practice to go in the draw to win a pair of non prescription Bolle sunglasses - it is that easy. Tell your friends, everyone can enter.

Things we can see in your eyes.

As part of every eye check we examine your eyes with a microscope - have you ever wondered what we can see? Here is the big reveal!

A lot of the tissue in the eye is transparent - so that light can pass through to get to the retina. Let’s start at the front - the cornea. We often see evidence of previous infections or injuries. In the fluid filled chamber inside the front of the eye our microscope allows us to see cells floating. Checking the lens we look for early signs of cataract. Then we see the vitreous gel, where we often find the ‘floaters’ which people describe for us. Finally the retina comes into focus.

The retina is red - sometimes seen as a red eye in photos taken using a flash. We have a check list as we examine the blood vessels, the optic nerve and the macula.

Sometimes we want to go deeper - to ‘look’ at the layers of the retina in more detail. This is when we use OCT scanning technology. While the information this provides is quite amazing, it does not quite match to viewing down the microscope - seeing individual red blood cells tumbling along the capillaries at the front of the eye will always be special for me.

International Myopia Congress Tokyo

In September I was fortunate enough to attend the International Myopia Congress, held in Tokyo (just ahead of the Rugby World Cup). Myopia, or short-sightedness, means vision close range is clear but things further away (TV, the board at school, road signs) are blurred.

As global rates of myopia increase rapidly, particularly in South East Asian countries, there are concerns about the long term impact this will have on future eye disease (risk of retinal detachment, macular degeneration and glaucoma increase with myopia).

The four day congress brought together researchers, academics and clinicians from all around the world and sessions were presented by authors of clinical and scientific research.

The community is trying is understand what causes myopia. This effort included studies into genetics as well as animal research. Other projects look at epidemiology, trying to figure out who is effected and identify environmental factors which may play a role. So far we know the importance of two hours per day time spent outdoors will delay the onset of myopia in children.

One day was dedicated to studies following intervention strategies, such as ortho-K contact lenses, and soft contact lens designs.

Rising rates of myopia have been described as an epidemic, and resulted in some large scale public health initiatives in Taiwan and Singapore. It was inspiring to hear from individuals who had played vital roles in pushing these program’s ahead.

800 delegates attended in Tokyo. The next congress will be in Rotterdam in 2021.