Nearsightedness (Myopia)

The inability to see distant objects clearly is the most common vision problem of childhood. It rarely occurs in infants unless they were born prematurely. Around the age of two years, however, some children become nearsighted, and the number of children with the problem steadily increases throughout the school years, peaking in adolescence.

WHAT CAUSES NEARSIGHTEDNESS?
Nearsightedness results from a refractive error, which is an error in the way the eye bends the entering light rays that the brain translates into visual images. In normal vision, light rays converge and focus precisely on the retina, the visual apparatus lining the back of the eyeball. In nearsightedness, the eyeball is too long from front to back, so light rays converge somewhere in front of the retina. The result is blurring of objects that are more than a few feet away. The farther objects are, the more blurry they appear.

A tendency to be nearsighted runs in families, although many children with nearsighted parents have normal vision. It occurs with particular frequency in children with Down's syndrome, affecting 30 to 35 percent.

WHEN SHOULD I SUSPECT THAT MY CHILD IS NEARSIGHTED?
Nearsighted children believe that everyone sees things the way they do, so you should not wait for the child to complain about poor vision. Look for behavior such as frequent eye rubbing, sitting close to the television, holding the head at an unusual angle, squinting and clumsiness. A small number of nearsighted children may complain of dizziness and headaches.

The problem may not become apparent until the child starts school, at which time the inability to see pictures or writing at the front of the classroom may impair performance. Teachers generally notice such problems before the child falls far behind. Many parents find out about their children's vision problems as a result of school vision screenings.

Nearsightedness and other vision problems are often detected in the course of routine pediatric visits. Doctors start checking babies' vision at about the sixth to eighth week of age, when the ability to focus first emerges. Although precise measurements are not possible at this age, the doctor will watch the baby's eyes move together and one at a time (with the other eye covered) while following an object. By age three, children can be screened with cards depicting familiar objects to determine a rough estimate of vision. Preschoolers and early school age children can be assessed using the Titmus test machine or letter E cards.

IS MEDICAL ATTENTION NECESSARY?
Yes. Even the youngest nearsighted children need an assessment and, in most cases, glasses to correct the refractive error responsible for the problem.

WHAT TREATMENTS ARE AVAILABLE?
The normal treatment for myopia is to wear corrective lenses (usually glasses), which should be prescribed by a pediatric ophthalmologist, a doctor who specializes in children's eye disorders. Pediatric ophthalmologists usually have a range of vision tests geared to the abilities of children, so they can measure the child's vision most accurately.

Since children's eyes grow and change rapidly during the first six or seven years of life, those who are nearsighted may need frequent vision rechecks (and, possibly, new glasses) approximately every six months. Because contact lenses require extra care, they are rarely prescribed for young children except in special circumstances.

GETTING HELP
Call your doctor if:

• Your child's school nurse or teacher thinks the child may have a vision problem

• Your child acts like he or she may have trouble seeing

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.