Little Eyes Big Problems

A Malaysian eye survey revealed that our rates of blindness are comparable to other countries in the South-East Asian region however slightly higher than developed nations. The proportion of partially-sighted individuals however was higher than average and is something that we need to address as a nation. Many of these cases included those who had uncorrected refractive errors (ie. Needing glasses) or cataracts.

Children’s eyes and vision develop from the time they are born. Not only are their eyes learning to see but their brains are also learning to interpret these signals from the eyes. As such, the vision of newborn babies is very blurred and their appreciation of colours is primitive. Ensure you come up to around 8 to 10 inches away so they can see your face. It is therefore important to provide them with a rich, visually stimulating environment. Ensure they get to see plenty of high-contrast, colourful 3-dimensional toys. Cot-mobiles are especially good as the movement helps them not just follow the objects but also learn hand-eye coordination. For the first 2 months of life do not get alarmed if you notice your child’s eye wandering or becoming cross-eyed – their brain is still learning to control their eye muscles. If however this doesn’t settle down or is permanent then bring them up to an eye doctor.

Your baby will not be able to judge distances very well until around 5 months of age. It is after this that they begin forming a better idea of the 3-dimensional world around them. Things that you can do with your baby to stimulate their visual development include:

• Change their cot position in the room at intervals to give them a different ‘view’
• Keep large colourful toys within their reach
• Talk to them as you walk around the room so they learn to track you
• Let them creep and crawl on the floor and give them toys of different shapes & sizes to explore
• Roll a ball around the room so they learn to track it
• Play peek-a-boo

Up until the age of 10, your child’s eye and brain are still developing and ‘learning’ to see. If they are not provided with a good, clear vision which sometimes is in the form of spectacles, then the eye never learns to ‘see’ clearly and the vision in one or both eyes will never be perfect. This is called amblyopia or ‘lazy eyes’ whereby there are no structural defects other than the eyes and nervous system never having ‘learnt’ to see well enough.

The WHO initiated ‘Vision 2020’ in 1999 with the aim of eliminating the main causes of avoidable & preventable blindness by the year 2020.  One of the strategies it advocated was raising awareness of the causes of avoidable blindness and the solutions that can help eliminate it. Unfortunately, having no prior experience or reference, it makes it impossible for a child to alert parents of any abnormalities.

Some children have such poor vision that they are unable to keep up in class as they can’t see well enough to read books or the blackboard. This makes them crave stimulation from other senses and so they become fidgety and physically active. They are then labelled as attention-deficit or just plain naughty and are punished at school and at home. And all they ever needed were glasses! Some children have a problem in only 1 eye but because their vision is good in the other eye they carry on unaware of their problem. For these reasons, checking their vision is a matter of global importance as blindness or severe visual impairment has a significant socio-economic impact for every nation.

By Dr Manoharan Shunmugam

Consultant Ophthalmologist, Adult & Paediatric Vitreoretinal Surgeon at OasisEye Specialist.