By Erica Otoo, OD, Optometrist, Montefiore School Health Program Bronx Voice  

August 31, 2023

HEALTH - As a parent of a child entering the 7th grade, my back-to-school to-do list always includes purchasing clothing, uniforms, school supplies, and of course taking my first day of-school pictures. This is the case with many parents as well. And when it comes to our children’s health, we also make sure all vaccinations are up to date, we have an updated physical, and complete 504 forms for children who require special care and medications.

However, what is often overlooked when it comes to our children’s health during this decisive time is ensuring our children’s eye health and Vision is at its best. This includes an annual comprehensive eye examination and a current eyeglass prescription if necessary.

August is back-to-school month, but it is also Children’s Eye Health and Safety Month. Success in school requires excelling in math, reading, and writing. Learning is 80% visual – just think of all the visual tasks children undergo in the classroom and at home. Studies have shown the positive effects of vision correction on academics for all grades.

Eye Conditions

The most common reason for vision correction is blurry vision or refractive error. The main refractive errors are myopia (near-sightedness), hyperopia (far-sightedness), and astigmatism.

Myopia is a vision condition in which people can see close objects clearly, but objects farther away appear blurred. It occurs if the eye length is too long or if the cornea (clear layer in the front of the eye) is very curved. Myopia is most often first detected in school-age children and will, unfortunately, progress until 21 years old.

Signs of Myopia include difficulty seeing the chalkboard/smartboard; difficulty seeing the television at home; squinting to see objects in the distance and, in severe cases, difficulty seeing near objects.

Hyperopia is a vision condition in which distant objects are usually seen more clearly than close ones. It occurs if the eye length is too short or if the cornea has very little curvature. Hyperopia is very difficult to detect due to most vision tests or concerns directed toward distance vision. A child with perfect 20/20 vision may still be hyperopic and exhibiting signs, including difficulty maintaining focus during near work; eye strain; fatigue and headaches.

Astigmatism is a vision condition that occurs when the cornea is irregularly shaped as a football or because of the curvature of the lens inside the eye. It frequently occurs with myopia and hyperopia. Signs of Astigmatism include blurred vision at any distance, eye discomfort and headaches.

In addition to addressing vision conditions, visual skills, including eye focusing, eye teaming (the ability to use both eyes when moving the eyes along a printed page), eye tracking, eye-hand coordination, and visual perception (the ability to organize images on a printed page into letters, words, and ideas and to understand and remember what is read), are important for effective learning. Eye conditions that can affect these visual skills are strabismus (crossed eyes) and amblyopia (lazy eye). Strabismus is the condition where both eyes are not looking in the same direction at the same time. The eye can turn either inward, outward, upward, or downward. Strabismus can involve one or both eyes, can alternate between the two eyes, or one eye can turn out constantly or at certain times. Amblyopia is a vision condition where one or both eyes have loss of clear vision or reduced vision. It can develop due to crossed eyes or a large difference in degree of far-sightedness or nearsightedness between the eyes. There is amblyopia treatment and if started by three years of age or earlier, can yield the best results. However, amblyopia treatment can be effective at any school age.

Identifying Color-Blindness

Identifying colors is essential in learning and teaching from pre-k all through college. Colors help children with organization, identification, and overall processing of information. Thus, it is important to get an eye exam to determine if your child may have red-green color deficiency also known as color-blindness. Red-green color deficiency can lead to poor academic performance. In elementary school, children are learning colors and using colors to analyze things such as maps or graphs in later grades. In middle and high schools, colors are used in general sciences, such as biology and chemistry, so it is important to know if your child has color-blindness. Unfortunately, there is no cure for inherited color-deficiency, but the awareness and acknowledgement allow parents and teachers to guide students with this condition and try other non-color-coded methods to enforce and enhance learning. 

Many schools also have sports programs, especially at the middle school and high school level. The visual skills listed above are also important in allowing your child to succeed in various sports. If you have a child in a sport currently, you want to avoid any sports-related vision issues. This includes providing your child with protective goggles to prevent injury.

Due to the pandemic, screen time is a hot topic for both children and adults alike. Excessive screen time has been shown to induce digital eye strain, increased myopia, and sleep disruption. Pediatric ophthalmologists recommend children have their device at arm’s length (16-30 inches away) and a slight downward angle (10-20 degrees) from children’s faces, they blink often to naturally moisturize the eyes, they take breaks from screens often – every 20 minutes they should look into the distance 20 feet away for 20 seconds to allow the eyes a chance to refocus, and they can play outside or with other toys to take a break from screens.

Seeking Care from an Eye Expert

Children can get comprehensive eye examinations with optometrists - primary eye care providers who examine, diagnose, treat, and manage diseases and disorders of the eye - at various locations such as hospitals, opticians, optometric centers, and private practices. Ophthalmologists – who also diagnose and treat conditions of the eye - are also located in hospitals and private practices.

At Montefiore Medical Center, we have optometrists and ophthalmologists to provide care for children. Additionally, the Montefiore School Based Health Program (MSHP) has 32 health centers located within schools in the Bronx. At many of those locations, we can now offer students eye exams and even free eyeglasses through our partners at Warby Parker.

MSHP is the largest and most comprehensive school-based health program in the country, The program provides coordinated primary and preventive healthcare, including medical care, dental care, mental health, and community health care, to public elementary, middle, and high school students throughout The Bronx and Southern Westchester County. One in four Bronx students is now at a school with a Montefiore School Health Program clinic. 

Remember, this back-to-school season it is crucial to take your children to an optometrist or ophthalmologist for a comprehensive eye examination as part of your preparation to ensure your child is well-equipped and prepared for a successful school year.