Children believe that everyone sees the same (good or bad) as them and that is why it is important to observe them


If children approach objects, they rub their eyes, they wink to see far away, they turn red, they get a lot of styes, they have a headache at the end of the day (after much visual effort), they turn their heads to see more with one eye than with the other. when taking photos, the reflection of one eye always comes out different from the other, they divert their eyes (strabismus) or they have more difficulty reading well, surely they have a vision problem. At least that is what Francisco Javier Hurtado Ceña points out, head of the Pediatric Strabismus and Ophthalmology section at the Rementería Clinic.

He explains that the most serious alterations appear a few days or months after birth: cataracts

congenital, congenital glaucoma, malformations, very striking strabismus… «It is normal for a child with no symptoms or family history to need at least one ophthalmological check-up at 4 years of age. At that age, any problem such as lazy eye can be treated and solved without problems.

Why don’t children usually complain?

They adapt to your situation. Since they have not seen better, they do not know what it is to see well. They have more ability to focus and therefore to compensate for prescription defects such as hyperopia (an adult with 3 diopters is fatal and a child does not even complain).

They do not close one eye to detect if they see better or worse. A child can see 100% in one eye and 5% in the other and neither he nor his parents realize it.

What has caused that in our country one in four children under 16 have myopia?

Genetic and environmental factors are needed for myopia to increase. The genetics are not able to explain the increase in myopia because it is happening in a few years, so the explanation lies in the environmental ones.

Close-up activities (reading, mobile, studying, computer, Tablet…) cause myopia and, therefore, the educational level of the population leads to an increase in myopia.

Is it the most common sight problem?

Myopia is one of the most frequent anomalies and, above all, it is more likely to cause diseases or blindness, although in total terms, hypermetropic children are more common in childhood (we could speak of 60% compared to 20%-25% of myopia). . Children are born with farsightedness, which decreases with age and at 18 years of age they have a normal eye. Translated: Children are born with a small eye, it grows with age and at 18 years of age it has a normal size. A child, at birth, should have 3 diopters of hyperopia and at 7 years more or less 1.5 diopters. If at the age of 7, instead of 1.5 diopters, he has 0 diopters, he is going to be myopic for sure.

What can parents do to avoid it?

The recommendations that we give in the consultation so that myopia does not increase are to move close objects away and spend at least 2 hours a day outdoors. In children who we know are going to be myopic, we also give these recommendations because they delay their appearance.

What new treatments can help combat this vision problem?

1. Become aware that it is an avoidable problem or at least that it can be stopped.

2. The appearance of contact lenses for myopia control:

to. Daily disposable soft lenses. They are soft lenses (they bother less) daily disposable (they do not need as much hygiene as others that last longer). They are put on in the morning and thrown away at night.

b. Night lenses. They are hard lenses (they bother more) and expire after a year (they need hygiene because they are more likely to be infected in children). The good thing is that they wear them at night and do not need glasses or contact lenses during the day.

3. Appearance of glasses to control myopia. From my point of view, they still lack sufficient scientific evidence, but it is a promising future. They are glasses with a design similar to soft lenses.

4. Drops to stop myopia. They are drops of a compound called atropine. It is put every night in both eyes for at least 2 years. It can cause dilation of the pupil or poor distance vision, but only in less than 3% of children. The problem is that you have to use it for at least 2 years because, if you use it for less time, myopia may increase more than it would have if you had never used the drop (rebound effect). This drop does not remove the graduation. With it, you have to wear glasses, normal contact lenses, soft lenses to control myopia or contact lenses at night.

5. Combined treatments. Either lens can be combined with atropine and the effect is greater than either treatment alone.

Are contact lenses harmful to young children?

There is a widespread fear among ophthalmologists who do not see children that a contact lens will cause an infection. The truth is that it is very unlikely and the benefit we are causing by avoiding diopters in the future is greater than the risk of a possible infection.

These lenses should be considered a treatment. Our intention is not for the child to stop wearing glasses (also), but for them to have fewer diopters so that they have fewer chances of losing vision in the future. The efficacy of these treatments varies between 50 and 80% control of myopia growth.

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