What you need to know about your child’s vision

  • By Heather Holtschlag
March 1, 2017
Dr. Jane Hughes of Pediatric Ophthalmology and Strabismus, Inc., examines the eyes of her patient, Abigail Seibert. - Katie Green

As it turns out, your mom may have been right when she said that we should eat our carrots to maintain our eye health.

“Carrots contain Vitamin A, which is important for healthy vision,” says Dr. Jane Hughes, pediatric ophthalmologist at Pediatric Ophthalmology and Strabismus, Inc., which has offices in Washington County, Cranberry Township and Murrysville. “So are vitamins C and E, zinc, lutein, zeaxanthin and omega-3 fatty acids. Eating a well-balanced diet full of vegetables, fruit, lean protein, fish and nuts is the best bet (for maintaining healthy vision). A multivitamin is not a bad idea for picky eaters, but I caution using supplements in children. Always check with your pediatrician first.”

Hughes says that healthy eyesight begins at birth and explains that the eyes undergo considerable growth during the first two years of life, followed by another growth spurt around puberty.

“Babies are not born with 20/20 vision,” she notes. “Initially, a newborn will respond to light and high contrast (black and white) objects at 8 to 12 inches best in peripheral gazes. By three months, babies should be able to fixate and track objects, and by six months, they begin to judge distances and reach for toys.”

Development continues, and by age 3, a child’s vision is expected to be 20/50 or better, according to Hughes, who also serves as a clinical instructor of ophthalmology at the University of Pittsburgh School of Medicine. By age 4, the vision is expected to be at 20/40, and by age 5, children should be able to read the 20/30 line or better on the eye chart. An eye specialist should evaluate any child who is not meeting these visual milestones.

Dr. Hughes offers the following tips to help ensure your child sees things clearly:

1. Be sure your child has a preschool vision screening, and follow through with any abnormal results.

2. Use appropriate eye protection. Trauma is a preventable cause of vision loss in children. Wear approved polycarbonate protective eye wear for sports and recreational activities, including dangerous yard work and home projects. Make sure your children are using age-appropriate toys.

3. Teach your children responsible use of technology. Smart phones, tablets, computers, video games and TV have changed the way we live. The consequences of excessive screen time on children’s development, physical well-being and their eyes are just starting to be recognized. From an ophthalmic perspective, long periods of screen time are known to cause dry eyes, and there also concerns that screen time is leading to increasing myopia and exacerbating certain forms of strabismus. Blue light exposure is being investigated with concerns of association with macular degeneration. The Academy of Pediatrics has issued recommendations on age appropriate use of technology on their website, aap.org.

4. Stay physically active. Get outside at least an hour a day, and don’t spend all of your free time in front of a screen.

“Vision screenings start in the newborn nursery followed by periodic evaluations by the pediatrician during well-baby and child exams,” Hughes says. “However, a thorough vision screening performed by a trained professional is recommended for all preschool children between ages 3 to 5. A child should certainly be seen by an eye specialist earlier if there is a family history of childhood eye disease.”

Some of the more common eye issues that Hughes sees in her office include amblyopia, or “lazy eye,” which is weaker vision in one or both eyes due to abnormal development of the visual system when the brain and the eyes are not working together. Strabismus is a misalignment of the eyes, and can cause the eyes to cross (esotropia), drift out (exotropia) or vertically separate (hypertropia). Myopia, or nearsightedness, is a common complaint she hears from students who say they can’t see the chalkboard at school, as are hyperopia (farsightedness), and astigmatism, which is an irregular curve of the eye. These conditions can lead to blurry vision and often require a complete exam to determine if the child needs glasses.

“As a pediatric ophthalmologist, I see a lot of the complicated medical and surgical eye problems,” Hughes says. “However, as a community eye doctor, I get great satisfaction watching a child put on their first pair of glasses, suddenly look around and get a big smile on their face.”

Part of her job also entails dispelling the myths often associated with maintaining healthy vision. Two such myths Hughes hears frequently are that wearing glasses will make the person dependent upon them or even make their eyes weak. The other is that sitting too close to the television will hurt your sight.

“These are both false,” DHughes says. “Glasses may save a child’s vision. Once a person is seeing clearly with glasses, they may not want to go back to blurred vision, but this is not dependency. And sitting too close to the television may give you a headache, and it certainly makes it harder for others to see the screen, but it will not damage eyesight.”

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