Posted tagged ‘vision’

Want kids to see better? Send them outside

September 24, 2015

The Pediatric Insider

© 2015 Roy Benaroch, MD

This month in JAMA, physicians from China reported a large, randomized trial – and it turns out that, at least in China, more outdoor time means fewer kids need glasses for nearsightedness.

About half of 1900 students from 12 schools were randomized to either get an extra 40 minutes of outdoor play each school day, or continue their usual routine. They were followed for three years and then assessed for nearsightedness, or myopia.

In the control group (with no extra outdoor time), 40% of the children were myopic by the end of the study; those who got extra outdoor time reduced their risk to 30%. The risk remained about the same when parents’ eyesight was factored in. And among children who were myopic at the start of the study, their vision worsened more quickly if they didn’t get the extra outdoor time.

It’s been observed that a lot of close-up work in young children seems to contribute to myopia. About 90% of young adults in the East Asian countries of China, Taiwan, and South Korea are myopic, compared to 20-30% in the UK. Rates have risen dramatically in these Asian countries as academic pursuits have begun to dominate their early educational experiences—and perhaps the close reading work, instead of playing outdoors, is to blame.

It’s not clear whether increased outdoor play would decrease myopia in the USA—but this is just one more potential plus for outdoor activities. Now stop reading and go outside!

Vision therapy for dyslexia and reading disorders

September 14, 2015

The Pediatric Insider

© 2015 Roy Benaroch, MD

Dyslexia is a specific learning disorder—a problem not with intelligence or a lack or trying, but with the ability of children to learn to read. It affects 3-20% of children (depending on the exact definition used). Because reading is essential to school success in almost every subject, problems with reading need to be addressed as early as possible.

One kind of therapy for dyslexia is based on the premise that reading problems are caused by vision problems—though the scientific community isn’t convinced that this is the case. The large, national professional bodies representing pediatricians, ophthalmologists, and optometrists recommend only routine vision screening for children having reading difficulties. Nonetheless, there’s a cottage industry of so-called developmental or behavioral optometrists who offer a variety of services commonly called “vision therapy” to help with reading problems and other developmental challenges. There is very little objective evidence that any of these therapies offer more than short-term improvement. Besides, they’re very expensive, and often not covered by medical or vision insurance. Parents need to know whether this kind of therapy is worth pursuing.

Researchers in the UK published a study in May, 2015, looking at a large number of children in a birth cohort from the early 1990’s. These children had all had thorough serial health assessments as they grew. For this specific study, they found that 3% (172 kids) in the birth cohort of 5822 children met objective criteria for reading impairment. All of these children had a very through vision evaluation, and most of those were completely normal; the small number of reading-disabled kids who weren’t 100% normal on their vision assessment had subtle abnormalities. The authors concluded “We found no evidence that vision-based treatments would be useful to help children with severe reading impairment.”

A strength of the study was that it was population-based—it didn’t just include children referred to a clinic because of problems. And the findings were objective and validated. However, the authors only looked at the most severe level of reading impairment. It’s possible they may have missed vision issues in less-affected children (though one would think, if vision were the root of reading problems, that the worst readers would have the most egregious and easily-identified vision problems.)

This study adds to the weight of evidence that “vision therapy” is unlikely to be useful for reading problems, and may be a waste of time and money.

Don’t sit so close?

February 6, 2010

The Pediatric Insider

© 2010 Roy Benaroch, MD

Will sitting too close to the television hurt your eyes?

No.

As recently reviewed in a short article from Scientific American, there’s no risk to eyesight from watching TV too close, despite what momma told you. Apparently there was a television sold in the 1960 that was recalled because of excessive radiation, which may have led to the lasting myth of too-close television watching hurting a child’s eyes.

Kids who are nearsighted might prefer to sit closer so they can see better, but it’s not the television that caused the vision problem. Actually, most children I see whose parents are worried about vision issues because of close-watching have perfectly normal vision. I think some kids just like to watch sitting very close.

Television isn’t off the hook though– there are plenty of bad things that are related to excessive screen time: depression, poor speech skills (yes, even in toddlers who watch allegedly “educational” shows), overweight, and many other problems. TVs in children’s bedrooms are an especially bad idea.

So: though watching TV too closely won’t hurt anyone’s eyes, the best distance to watch a television is far, far away. From a different room, or a different house.

There’s nothing good on, anyway!