I can see clearly now

Last year, when the optometrist told me my then six-year-old son, Roan, is far-sighted and has a lazy eye (just like me), I was surprised by my reaction. I was simultaneously sad, irritated and guilty — my boy was no longer “perfect” and my bad genes were to blame. It was a flashback to grade seven: I felt so dorky in my humongous glasses that I would put them on to hurriedly read the board and then immediately stuff them back in my desk. I remembered the fights with my mom over the exercises I refused to do to strengthen the weak eye. Why couldn’t my child have been blessed with my husband’s perfect vision?

Luckily, I’ve discovered that getting glasses isn’t as big a deal for kids today — in fact, it can be a positive, fun experience. Frames now come in such cute colours and styles that my son’s friends were envious. Best of all, Roan now has crystal-clear vision.

The process was eye-opening for his mother as well. Read on to find out what I learned about children’s eye health, and how to avoid some of the common pitfalls if your child has a vision problem.

When should children have their first eye exam?

Although the Canadian Association of Optometrists suggests testing babies as early as six months of age, your paediatrician will check your child’s vision from the very first well-baby visit. By the time he’s three (or when he starts preschool), if you have concerns about your child’s eyesight, your doctor may recommend taking him to an optometrist, who will test for near- or far-sightedness, astigmatism and other eye health problems. The next appointment should be before he enters kindergarten, and after that he should be seen annually, or at the optometrist’s recommendation.

It’s best not to rely on school vision screenings as they only test for 20/20 vision (meaning your child can see what the normal eye can see at 20 feet). Other problems, such as a turned or lazy eye, are often missed at school and home. “Never just wait for signs of vision problems,” says Susana Sebestyen, an Oakville, Ont., optometrist, noting that 80 percent of school learning is based on vision. “Children don’t have anything to measure their vision against. They think the way they see is normal.”

Many eye health and vision problems are hereditary, so it’s especially important that your child be examined early and regularly if family members have eye problems. My son never exhibited any of the common symptoms: I just took him because I know vision problems run in the family (see What to watch for). How do I find an optometrist who specializes in children?

Few optometrists specialize in children, but many are comfortable treating youngsters. Check opto.ca to search online. “Phone and ask if they do exams for children regularly. You can also ask other parents for recommendations or just go in and see whether the office is child-friendly,” says Okotoks, Alta., optometrist Tanya Lambden.

What should I look for in a frame and lenses for kids?

For lenses, try to find unbreakable polycarbonate, the stuff used in car headlights. For frames, get something durable and flexible. You want spring hinges, but steer clear of half-frames or frameless glasses. “Look for a one-year warranty: Kids use warranties,” says Bridgewater, NS, optometrist Erin Sheppard.

How do I get my child to wear her glasses?

The key is to let kids pick their own frames. “They won’t wear them if they don’t like them,” says Sebestyen. Some kids’ frames have favourite characters, such as Dora, on the inside of the temples. A bespectacled role model might help; in the Arthur books, D.W. pretends she needs glasses when her brother gets a pair. And “lots of kids want glasses like Harry Potter,” says Sheppard, noting that even children with perfect vision try to give answers during exams that will get them a prescription. “I can tell right away if they really want glasses.”

Some families incorporate the child’s glasses into regular routines. Sheppard knows of one four-year-old girl whose parents say good night to her glasses before she “puts them to bed” in their case, and then help her “wake them up” in the morning. “It makes the glasses a normal part of her day.”

Although many parents expect resistance, most kids are happy to wear their glasses once they literally see the benefits, says Sheppard. “The key is to stay positive.”

When can my child wear contact lenses?

Most optometrists won’t consider them for children under age 12. It’s a decision between the parent, child and optometrist. “The child has to be mature enough to look after contacts,” says Lambden.

Can children have laser eye surgery?

No. “The eye is still developing into the early 20s, so most optometrists recommend waiting until then for laser surgery,” Lambden says.

Children will take their cues from you in the attitude department. Although I thought I had on my best poker face when we got Roan’s diagnosis, he saw right through it and immediately refused to wear glasses. “It’s normal for parents to feel surprised or even guilty,” says Sheppard. “But they have to realize how important it is for their child to wear the glasses.” I made a point of wearing my own glasses, rather than contacts, in solidarity with Roan after he was diagnosed. But it was Barbara Park’s irrepressible character Junie B. Jones who helped dissolve his initial reservations — in the book First Grader (At Last!), she brings her purple frames to show and tell and becomes a classroom hero. Now Roan is often stopped by strangers who compliment him on his burnt-orange frames. He always whips them off to flaunt the shiny green tips that curve around his ears. Prescription lenses aren’t always enough — sometimes the brain needs retraining to get the eyes working together (in the case of crossed, turned or lazy eyes). The optometrist develops a vision-therapy program to improve skills such as eye movement, control, focusing and coordination.

Exercises using lenses, prisms, filters, patches and even computer programs are taught. Getting kids started on the therapy early is best, though even adults can benefit.

Vision therapy takes time (weeks to months) and doesn’t necessarily “cure” eyes or mean your child gets to toss her glasses. Improvement also depends on following through with the homework.

Sometimes vision therapy is prescribed for kids who don’t need glasses but need to work on eye-hand coordination or have attention deficit disorder or binocular vision. However, it’s not a substitute for glasses for those who need them.

What to watch for

According to the Canadian Association of Optometrists, your child may have a vision problem if she:

• loses her place while reading • avoids close work • squints • holds reading material closer than normal • tends to rub her eyes • has headaches • turns or tilts her head to use one eye only, or closes one eye while reading • makes reversals (for example, b for d or 3 for E) when reading or writing • uses her finger to maintain her place while reading • omits or confuses small words when reading • performs below potential academically • sits too close to the TV • closes one eye while reading