Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, April 27, 1995 TAG: 9505060003
SECTION: PARENT'S GUIDE PAGE: PG-8 EDITION: METRO
SOURCE: SARAH COX
DATELINE: LENGTH: Medium
But aren't vision problems detected during elementary school vision screenings done by a school nurse or P.T.A. volunteer? Isn't that enough?
No, said pediatric ophthalmologist Dr. B. Allen Watson. Even he didn't know his own son had vision problems until he examined him in his office. Luckily for Watson's son, he was 3 1/2 years old, still young enough to treat successfully.
According to the American Academy of Ophthalmology, early detection of defective vision provides the opportunity for more effective and less expensive treatment. Amblyopia, which is poor vision in an eye that didn't develop normal vision along with the other eye, is the main reason to have a child screened.
The Academy says that after age 8, a child rarely receives effective treatment for this ailment.
"The younger the child is [at treatment], the greater the success,'' said Watson.
Strabismus is misalignment of the eyes, and one of the causes of amblyopia. The latter is a common condition, affecting approximately four out of every 100 people. According to Watson, there is a misconception that the cursory vision screening, done in a doctor's office during a child's pre-kindergarten physical and again throughout school, is sufficient.
Yes, measuring vision is the most important step, he said, and usually if a child sees well with both eyes there are no problems. But amblyopia and strabismus cannot be detected with the vision screening. The screening is not a diagnostic procedure and cannot detect that which can be seen by an ophthalmologist, who is a medical doctor with special equipment.
Watson explained that it takes two good eyes to have good depth perception. With one eye affected, a person can't get a commercial driver's license or become a pilot. The problem may have cosmetic implications as well, he said.
Watson said he's seen children with one blind eye who were intelligent and doing well in school. But eye problems can affect their athletic ability and it can affect their grades, because it is like a handicap. And he cautioned that there is a familial tendency in these problems, so he always screens siblings if something is detected in a child.
An ophthalmologist differs from an optometrist, who can prescribe glasses and has an advanced degree, in that he is a medical doctor with more training. An optician doesn't have to have any degree, and his role is to measure frames from a prescription. Although Watson said that he doesn't believe it's necessary to take a child to a pediatric ophthalmologist, you may want to consider one for special problems. All ophthalmologists spend some of their residency training in pediatrics, he said.
In preparing a child for a visit to an ophthalmologist, Watson said about all you can do is to point out there won't be any shots, but the eye drops will sting for a few seconds. Right after he applies eye drops, Watson asks his patient to go over to the toy box in his office and pick something out to play with, thus getting the child to open his eyes. He even exams babies for glasses.
There are some warning signs parents can be aware of. These signs will not indicate amblyopia or strabismus, but may indicate myopia (nearsightedness), which is the most common reason for glasses in ages 6 to 11.
If a child gets headaches after he or she uses the eyes, either reading or watching television; if a child rubs his or her eyes; or if his or her eyes are red, the child may need glasses. According to Watson, one in 20 preschool-age children wear glasses. That figure escalates to one in five from the first grade on, and the peak age of going into glasses is age 9.
LaVerne Davis, R.N., school health coordinator for Roanoke County, said the county, through P.T.A. volunteers, gives visual screenings in the fall of every year to grades kindergarten, third, fifth, seventh and tenth.
According to Watson, Roanoke City gives them to every grade, kindergarten through twelfth, but Davis said the city has a nurse, at least part time, in every elementary school, which may facilitate the screening frequency.
Davis said if a child fails the screening, another screening is scheduled. This one is done by a public health nurse. If this second screening is failed, a note goes home with the child recommending a visual eye exam. In addition, the public health nurse follows up with a phone call to make sure an exam has been scheduled.
Watson said usually the person doing the screening will be overly cautious, recommending follow-up if there is any question.
There's another bit of bad news: Eating carrots won't improve your vision. And sitting close to the television, reading in dim light and wearing the wrong kind of glasses do not cause poor vision. But not getting an eye exam could be harmful.
by CNB