When a baby is first born, their vision is thought to be 20/400, but within a few months after birth, a baby’s vision becomes more clear and by age 3 – 4 years, they typically have 20/20 vision. As a parent, one of your many jobs is to help them develop healthy vision and then to keep their eyes healthy and safe as they grow and reach their vision milestones. Your pediatrician will also do age-appropriate eye screening exams to monitor for any problems, but parents tend to be the ones who catch more subtle issues and should bring up any questions or concerns they may have. In our office, we use Go Check Kids starting at age 1 so that we can do vision screenings years before a child can cooperate with a vision chart.
Early on, it is important to help to visually engage your child as a newborn, infant and toddler so they learn to focus on objects and develop a wider field of vision. They also will develop hand-eye coordination by playing games like peekaboo and eventually things like patty cake and catch. There are also certain nutrients that can promote healthy vision, specifically zinc, vitamins A, C and E, omega-3 fatty acids and lutein. Vitamins C and E (found in fruits such as oranges, strawberries and mangoes) help prevent infections whereas vitamin A (spinach, kale) can help avoid dry eye and issues with night vision. Omega-3 fatty acids found in fish, chia or hemp seeds also help with dry eye and prevent future risk of cataracts and Age-related Macular Degeneration. In general, eating a healthy diet will promote healthy vision as it helps prevent chronic conditions (obesity, diabetes, heart disease) that also will affect eye health.
As kids get older, it is important to make sure to limit their use of digital screens, which has become a big issue due to the pandemic and resulting distance learning. Research indicates that babies as young as 6 months will focus and track digital devices and that by their teenage years, some kids spend up to 7 hours daily staring at a screen- and that excludes school work. Screen breaks are very important as too much screen time can lead to eye fatigue, blurry vision and dry eyes. The most concerning problem is that there seem to be rising rates of myopia (nearsightedness). In 2000, the prevalence of myopia was a bit less than a quarter of the population and by 2050, that will likely grow to 50%. There is concern that this might be due to increased screen time which causes eye muscle strain and accommodation spasms, which occur when you are gazing at the same distance for an extended time and your focusing system temporarily locks up or spasms. Please see Dr. Abrams piece on Computer Vision Syndrome for tips on healthy screen use or see a guide on the AAP’s Healthy Children page here. Most importantly, make sure you are modeling good behavior when it comes to screen time limits!
Finally, if you are going to be outside or active, make sure to protect their eyes by using appropriate eye wear. Even parents that are good about wearing sunglasses themselves struggle to keep sunglasses on their kids, so we all need to strive to be better. You should choose sunglasses that block 99-100% of UVA and UVB rays and opt for polycarbonate lenses that tend to withstand more wear and tear. It is typically best to let a child have a say in the style of their glasses once they are able to do so, as that may make it more likely that they will wear them. And of course, model good sunglass-wearing habits so they can follow your lead.
Jackie Phillips, MD, June 30, 2021
