Eyestrain Reality Check
It's always an anxious time when children complain about the way they feel. Parents become even more concerned when symptoms relate to the eyes.'My child has eyestrain. What could be wrong?!?'
Most of the time nothing is wrong but it should never be assumed. Parents are the child's ultimate advocates. No matter what anyone else thinks, the parents have to trust their children and do right by them - even if a comprehensive eye exam is perfectly normal.
Now there is new research about children and eyestrain complaints that has been published in The American Journal of Ophthalmology. 1,448 children were enrolled (the parents consented on behalf of their underage children).
220 children in this prospective study were complaining of eyestrain or headache and 82% were found to have a normal eye exam. Here's what they found in the remaining children (exceeds 100% because some children had more than one finding):
- 15.0% had an uncorrected refractive error
- 3.6% had some amount of lazy eye (amblyopia)
- 7.3% had strabismus (misalignment)
Compare those numbers with the 1,228 children who did not complain of eyestrain or headache.
- 9.9% had an uncorrected refractive error
- 1.4% has some amount of lazy eye
- 1.8% had strabismus
Now, here's an interesting twist. Looking at the entire group of children as a whole:
- 78.7% of all children with refractive errors never complained of eyestrain or headache.
- 68.0% of all children with amblyopia never complained of eyestrain or headache.
- 58.0% of all children with strabismus never complained of eyestrain or headache.
So, what does this study teach parents? It teaches them that 'You never know!' Fortunately, the odds are good that a child complaining of eyestrain either has no eye problem or a very fixable eye problem. It is also a powerful reminder that parents and families cannot predict whether or not a child's complaints are genuine. Remember, parents, you are the child's ultimate advocates.
REFERENCE: Ip JM, Robaei D, Rochtchina E, Mitchell P. Prevalence of eye disorders in young children with eyestrain complaints. Am J Ophthalmol 2006;142(3):495-7.
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Technorati Tags: vision problems, children, lazy eye
5 Comments:
I have a question for you, Dr. Lloyd. How do very young children get diagnosed? I saw a young 2-year-old wearing eyeglasses the other day and I wondered how he could have been diagnosed before language skills (much less readng skills) were in place.
Refractive errors can be measured in newborn infants. It's called retinoscopy, a painless exam using a hand-held lens and a illuminated peek-a-boo device.
DO A BARREL ROLL
It's Liz from I Speak of Dreams.
Dr. Lloyd, would you do an article (or a series of articles) on vision deficits and learning disabilities?
In some circles, "vision therapy" is touted as a solution for learnig disabilites.
For example,
http://www.nbc11.com/mariannefavro/11235373/detail.html
New studies show one quarter of grade school students have vision problems, yet most of them never take a vision test.
Some of them wind up being misdiagnosed with other problems.
NBC4's Dr. Bruce Hensel said the study is crucial because vision problems can cause lifelong issues if not addressed early.
Hensel said it could all be prevented with some simple steps.
[snip]
Hensel said that it turns out there was nothing wrong with [a particular child's] learning abilities, or his behavior. He just couldn't keep his eyes on the page.
[snip]
As a result, many children like [a particular child] are thought to have ADD, or other problems.
"They act out because they're not comfortable in a classroom setting. Many of these children are also misdiagnosed as having a learning problem, when it's really a treatable vision problem," said Dr. Elise Brisco.
Optometrist Dr. Elise Brisco said vision problems cannot be diagnosed by looking at a standard eye chart. If a child has poor handwriting and drawing skills, difficulty catching a ball, or maintaining eye contact they could have a vision problem.
unfortunately, this should not be "new" news. eye doctors have known for years children have poor abilities to determine whether or not their vision is normal. we see it almost every day. its too bad the majority of medical professionals believe pediatricians are qualified to diagnose potentially vision threatening conditions. they are certainly highly trained, but not to the degree of those in the eye care field.
bottom line, its never too early to get your kids vision tested by an optometrist or ophthalmologist who is comfortable dealing with children and infants.
Dr. Lloyd, thank you for bringing this up...
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