Reading under poor lighting. Watching an unhealthy load of television. Constant use of hand-held electronic devices. These are current-day exposures that develop problems in the eyes of young children.

Children might not be able to communicate their difficulty in seeing as a result of these unhealthy activities — which in turn affect learning. It is thus important for parents to monitor for signs of eye problems their child might have.

According to Dr. Veronica Tay, Deputy Director of Student Health Centre and National Myopia Prevention Programme at the Health Promotion Board (HPB), ‘refractive errors’ in a child’s eye may develop between birth and the age of 6 to 9 years. The most common pre-school vision problems are refractive errors which range from far-sightedness hyperopia), to near-sightedness (myopia) and astigmatism.

Different kinds of problems with vision

Myopia, also known as short-sightedness, is a condition where distant objects are not clear. It is usually caused by an elongation of the eyeball that occurs over time Because of this, light entering the eye is not properly focused onto the retina.

Hyperopia, also known as long-sightedness or far-sightedness, is the condition where near objects are not clear. It is caused by a shorter eyeball or an abnormal shape of the cornea and is common in young children leading to strabismus (squinting).

Dr. Tay says uncorrected strabismus may lead to amblyopia or ‘lazy eye’. Amblyopia happens when the brain does not fully recognise images seen by the amblyopic eye, reducing the eye’s ability to see.

Astigmatism is due to an irregularly shaped cornea where part of it does not allow light to focus onto the retina. This result in an area of blur within a clear image. Astigmatism may occur along with either myopia or hyperopia.

Symptoms to look for

The following is a checklist for parents to watch for in their child:

  • complaints of distant objects appearing blur
  • consistently sitting too close to the television
  • holding a book too close to the face when reading
  • squinting or tilting the head for better sight
  • frequent rubbing of the eyes
  • displaying sensitivity to light and/or excessive tearing
  • closing one eye or frowning when reading or watching television
  • avoiding activities requiring near vision such as reading, homework
  • avoiding activities requiring far vision such as sports
  • complaints of headaches or tiredness in the eyes
  • making mistakes frequently when copying from the blackboard

Studies have shown children who spend more time on outdoor activities have less risk of developing myopia. Dr. Tay, however, points out the absence of proven preventive measures.

“Though we cannot prevent the development of these refractive errors, early detection and management is vital in correcting vision for better learning,” she says.

Two-pronged approach

The National Myopia Prevention Programme (NMPP), started in 2001, aims to delay the onset and progression of myopia using a two-pronged approach.

The first raises awareness for early detection and management of defective vision through public education, and promoting outdoor activities and other good eye care habits in children.

The second involves regular vision screening focusing on early detection, management and monitoring of myopia prevalence rate among children.

Dr. Tay says, “Vision screening can also indicate if a child has long-sightedness or astigmatism as these also manifest as blurred vision.”

To this end, vision screening is conducted for Kindergarten 1 and 2 students, primary school students as well as Secondary 1, 2 and 4 students as part of the annual health screening.

On diagnosis, younger children (K1, K2 and P1 students) found to have poor visual acuity (of Snellen 6/12 or worse) are referred to the Refraction Clinic at the Student Health Centre, HPB. Prescriptions are then given for spectacles to be made at optical shops. Children who require further assessment are referred to the Paediatric Ophthalmologists at the public hospitals.

Better eye care

Dr. Tay has the following tips for promoting better eye care for children:

  • Increase time spent on outdoor play.
  • Reduce time spent on unnecessary near-vision activity like games on hand-held electronic devices.
  • Enforcing breaks after 30-40 minutes of near-vision activity like reading, writing or working on a computer.
  • Ensuring keeping at least 50cm from the computer screen when using a computer.
  • Ensuring keeping at least 2m from the television when watching.
  • Ensuring reading is done at arm’s length, or at least 30cm from material.
  • Ensuring reading environment is well-lit.
  • Inculcating proper posture for any of these activities.

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Contributed by:
Early Childhood Development Agency