Eyesight

How this topic helps your child's learning

Unlike your teeth, your eyes don't normally let you know in an obvious way when something is wrong with them. Often, because sight deterioration can be very gradual, you genuinely don't notice that you aren't seeing as well as you could. This is particularly so with children.

This section is designed to raise childrens' awareness of their eyes and eyesight through an understanding of how the eye works, what can go wrong, and how poor eyesight can be corrected. It also encourages children to understand the need for regular eye examinations, as the sooner a problem is detected the greater the chance of successful treatment.

The software is designed to meet National requirements in the PHSE (Personal, Health and Social Education) and the ICT curriculum in England and the Health Education and ICT curriculum in Scotland.

The content is primarily aimed at KS2, SC4 pupils, although it has a great deal of information relevant to KS3, SC5 students studying Science and Biology.

The basics

Most parents know how important it is for their children to make a regular visit to the Dentist, but very few consider a regular visit to the Optician to be as important. But a child's eyes have to last for a lifetime. The child who cannot see properly may not be able to learn properly and although a child's visual problems may not remain with the child for life, the effects of poor educational and social development can.

Research carried out by the Optical Information Council shows that an estimated 1 in 5 children in this country could have undetected visual problems. Although the majority of these children will have perfectly healthy eyes, their ability to see may be impaired by focusing defects. This situation can be easily remedied with the help of spectacles.

Many parents are concerned that if they let their child wear glasses when he is small then he will "become dependent on them" and will always have to wear them. This is not so; if your child has to wear glasses it is because he has an optical condition which requires him to do so and nothing you can do will prevent this or postpone it. By preventing your child from wearing glasses when he ought to do so, you might at best be impairing his development and enjoyment of life, and at worst be making his condition worse.

The importance Boots Opticians place on children's eyecare is second to none and are always pleased to see children in our practices, and to make them feel at home whilst having their eyes examined.

For more advice and information concerning your child's eyes your Boots Optometrist should always be personally consulted. An eye examination for children is free, it doesn't hurt, and you can be with your child throughout the examination. Most importantly, you can discuss anything and everything about your child's eyesight and eye health with the Optometrist.

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Useful things to know

Eyecare During Pregnancy

During pregnancy changes take place which may, in a very small number of women, lead to changes in vision and, or, make contact lens wearing less comfortable.

Increased water retention by the body can lead to slight changes in the shape of the eye and hormonal changes can vary the composition of secretions in the eye making vision with contact lenses less clear. In some patients the eyes may feel drier which means that contact lens wearing times may have to be reduced.

Any changes experienced will be temporary but it is important to visit the Optician if any discomfort is experienced and your Optometrist
should be told about your pregnancy. It is inadvisable, because of the symptoms described above, to attempt to start wearing contact lenses for the first time if you are pregnant.

How Babies See

Although their eyes are not yet fully developed, babies can see from birth. During the first few months they can only focus on objects that are close to them for example, a face close in front of them is clear but objects at the other side of the room will be a blur. The distance that they can see gradually
increases with age.

The importance of vision is obvious to any parent; within two weeks the new born baby will begin to recognise its parents faces and by four to six weeks will start to smile.

To begin with, the baby will enjoy looking at familiar faces and coloured objects. By about six weeks old the baby's eyes will be able to follow a brightly coloured moving object held about eight inches away, and by six months old he can see across a room.

Some babies appear to squint in early life. As a parent you may worry as your child's eyes may seem to wander and sometimes appear a little crossed. These effects may be due to the presence of skin around the eyelids. However, if you remain concerned after a few weeks you should consult your Family Doctor or Health Visitor.

When to Start Visiting the Optician

It is never too early to take your baby or child to have an eye examination if you have any concerns regarding his eyesight. It is important to remember that your child does not have to be able to read, or even be able to talk coherently, in order to have a thorough eye examination. At Boots Opticians the essence of the examination of a child's eyes is a flexible approach which enables the tests and order of the examination to be varied according to the child's age and degree of co-operation.

If you have no specific concerns regarding your child's eyes then Boots Opticians recommend that he has his first eye examination around the age of three, much the same time as the first visit to the Dentist. In the first instance, we suggest that your child could sit on your knee and "join in" when you have your own regular eye examination, or perhaps you could make an appointment for an older brother or sister, so that your younger child has a chance to see the eye examination in progress.

Your local Boots Optometrist will be happy to advise you if you have any query with your child's eyesight and he will be able to refer your child to your Family Doctor if this is required. The earlier an eye defect is found the more chance there is of correcting it and ensuring good vision for the child in future years.

How Parents Can Help

Babies and young children have no way of telling if they have impaired vision since they have no comparisons they can make. So parents have an important role to play in watching out for warning signs, for example children who don't want to play with toys, aren't interested in pictures, are clumsy, and so on. No one will know a child better, and be able to spot symptoms quicker than the child's parents. If you do have any concerns then ensure your peace of mind by having your child's eyes examined by an Optometrist.

Starting School

When your child starts school for the first time he will perhaps begin to use his eyes to a greater extent when reading and looking at distant chalkboards or television screens. This may also be the first opportunity for your child to compare his or her own eyesight against their peers. For example, during games he may discover that a distant score board is unreadable whilst the rest of the class are having no difficulty with it at all.

It is usual therefore for a great number of children to begin to visit their Optician around the age of five. It is important to remember that leaving a first visit to this age may mean treatment for previously undetected problems could be less effective.

Many schools will arrange' visits by medical staff for general health checks. These checks may reveal eye problems and your child may be referred to an Optometrist through one of these examinations. It is usual in this instance for a letter to be sent to a child's parents by the school explaining the recommended course of action.

Common Eye Problems

Poor eyesight is sometimes hereditary and there is a greater chance of a child having vision problems if there is a history of poor vision in the family. Amblyopia or 'lazy" eye, long or short sight and astigmatism are the most common of the inherited vision defects. Strabismus or squint is another condition which can affect young children. Most of these conditions can be corrected if caught early enough and each one is described on the following pages.

Long Sight
Hyperopia or long sight occurs when the eyeball is too short or the power of the eye too weak. The image therefore comes to focus, theoretically, behind the retina. This condition is so common in children that a slight degree of it can almost be regarded as normal and rarely needs attention. However, long sight may cause the eye to make too much effort to try to focus the picture and this may result in headaches, and in extreme cases, a squint.

Short Sight

Myopia or short sight means that near vision is better than distant and is caused by the eyeball being too long, or refractive power of the eye too strong. The image is therefore brought to focus in front of the retina.

Astigmatism

Astigmatism is an irregular curvature of the front of the eye leading to distorted vision that can be associated with either long or short sight.

Colour Blindness

Most people are able to differentiate easily between colours. However 8% of males and less than 1% of females are unable to distinguish certain colours -generally shades of red and green.

Colour blindness is an hereditary defect which does not generally cause a problem in early life but if left undetected can be a problem in later life when it is essential to distinguish colour particularly in working environments.

At Boots Opticians all children are assessed in their ability to differentiate between colours.

Lazy Eye

An Amblyopic or "lazy" eye is an eye that did not "learn" how to see because of a co-ordination or focusing fault while the eyes were developing. The most common age for this type of problem to occur is up to the age of 5 years. If diagnosed at an early age Amblyopia can usually be corrected.

Squint

A squint is a condition where the two eyes do not look in the same direction. If you are concerned about a child's eye which appears to turn consult your Optometrist, Family Doctor or Health Visitor.

Your Optometrist will detect a squint by showing the child a target and by covering one of the child's eyes and then the other. This will assess if the child's eyes are straight. Further tests to look at how the eyes move together (motility) and how well they can look at a near object (accommodation and near point of convergence) will be made.

Eyes can be straightened by a variety of methods including the use of spectacles, exercises or surgery. For this treatment you may be referred to your Family Doctor.

It is important to remember when looking at a very young child that the fold of skin at the bridge of the nose can make a child's eye look as if it is turning inwards. This is not a squint and will diminish as the child grows. However, if you continue to be concerned regarding a possible squint, a professional should be consulted.

Children's Eye Examination

At Boots Opticians your child's eyes will be examined by a qualified Optometrist. Our staff understand the anxieties that can be felt by children and adults on a first visit to the optician, and our aim is to ensure that both you and your child are completely at ease during your visit. This will enable your child to relax and to enjoy the examination which in turn will assist the Optometrist in making an accurate assessment.

We positively encourage parents to accompany children in the consulting room; brothers and sisters are also welcome and we have a selection of toys in all our Practices to help keep them occupied during the examination. First of all, the Optometrist will explain the various stages of the examination to both parent and child. He will then go on to discuss with you any family history of problems with eyes, including specific problems with squints, "lazy" eyes or more unusual eye diseases.

Any symptoms your child has been experiencing will also be discussed, such as difficulties at school or in play activities at home.

Moving on to the actual examination itself, the first stage is to assess how well your child can see with each eye. Don't worry if your child cannot yet read letters as the Optometrist can easily make an excellent assessment of a child's visual ability without this. This is because for both adults and children the examination is made up of subjective tests (where you or your child tell us what you see) and objective tests (where no response is required from the patient). The objective test involves the Optometrist looking into the eyes using an instrument called a retinoscope, whilst changing lenses which the patient looks through. Each eye is tested separately and an accurate prescription can be determined without asking the patient to make any response.

For slightly older children who are still not yet confident of their letters, we can use a special test known as the Sheridan Gardiner Test. Here the Optometrist holds up shapes in the distance and asks the child to point to the corresponding shape on a card that the child is holding close by. For children that are able to read the traditional eye chart is used to assess distance vision and a special children's reading book such as "Tales From Beatrix Potter" will be used to assess close vision.

The Optometrist will ascertain whether your child has normal sight, long sight, short sight or astigmatism, and will then move on to assess the correct prescription for any such optical error.

Next, the Optometrist will check how well your child's eyes are working together and also investigate how the eyes judge depth. This test known as stereopsis, is carried out by asking the child to look through special glasses which should clearly reveal a three dimensional image.

Finally the Optometrist will check the health of your child's eyes. Using another torch-like instrument called an ophthalmoscope, he can look into the inside of the eye and examine the various structures as well as the blood vessels at the back of the eye. In children these are usually quite normal however in adults certain signs may give clues as to the general health of the patient. The Optometrist will also check the health of the area around the eye including the eye lids and also check the pupil is reacting correctly to varying light conditions.

The results of the examination will be considered together with any initial symptoms and the Optometrist will advise on what, if any, course of action is necessary. This will vary from spectacles being prescribed, a visit to the GP or, as in the majority of cases, no action is needed and you will be happy in the knowledge that all is well with your child's vision. The Optometrist will then advise you when you should visit again for a further free NHS eye examination for your child.

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Tips & treatments

Preparing Your Child for Spectacles

In the same way that you will want to prepare your child for a visit to the Optician you will probably also want to prepare your child for the new experience of wearing spectacles. Because parents have a mature view about wearing glasses, they sometimes forget that the most important influence on the child may be the occasionally cruel comments of other children. Some parents avoid bringing up the subject altogether as they believe it will be too difficult.

Our advice is to prepare your child as fully as possible including a full explanation as to why he needs to wear spectacles. There is evidence that if the parents have a mature attitude to wearing spectacles then their children do also.

Finally, you should aim to choose a frame that your child considers attractive and colourful as this will be one of the major determinants as to whether he actually wears the spectacles or not.

How to Select a Frame for Your Child

At Boots Opticians we have a wide variety of colours and styles but most importantly all our frames are designed specifically for children and incorporate the special features required to suit children.

We all know that frames for children must be strong and durable as well as looking good. But there are several other features that you should look for.

Firstly, a child's frame is not just an adults style scaled down. Children's frames need a lower bridge to accommodate the developing shape of a child's nose and to prevent a child from looking over the top. In considering the durability of the frame it is preferable to have sprung sides and be made of sturdy and safe materials. Many Boots Opticians frames have flexible hinges which can bend outwards as well as inwards thus ensuring a snug fit is maintained whilst helping to prevent the sides from being snapped off.

Soft nose pads are another feature to look out for on children's frames. These are especially light and extremely comfortable. For highly sensitive skins we are able to order hypo-allergenic models where there is no contact of metal on the skin - the temple and the bridge are made of hypo-allergenic plastic. We can also supply special frames designed to fit the tiny features of a 6 month old baby if required.

The old NHS frames are now a thing of the past and at Boots Opticians children can choose from a large display of frames - metal and colourful plastic, and even frames featuring children's favourite cartoon characters.

Which Lenses are Right for Your Child

Spectacle lenses can be made from either glass or plastic. A standard unstrengthened glass lens is not recommended for children as it may not survive the rough and tumble of children playing and should it break, slivers of glass become an obvious hazard.

Plastic lenses are generally recommended for children's spectacles since they are safer and lighter to wear than glass although they will be more susceptible to scratching and should be given a hard coating to help minimise this.

For even greater protection we recommend hard coated poly-carbonate lenses (fitted in suitable frames) which although more costly are virtually unbreakable and are also recommended for those adults who play hazardous games such as squash or cricket, where the chances of eye injury are relatively high.

Our Optician will be happy to explain all the various options to you and your child and assist you in choosing the right lenses for your child's particular needs.

Free NHS Eye Examinations and Spectacles

All children under the age of 16 years are entitled to free NHS eye examinations. Full time students under the age of 19 are also similarly entitled.

The length of time between eye examinations is determined by the Optometrist and the cost of the examination is always free - however often it is required.

Following an NHS Eye Examination, an NHS Voucher will be issued if your child requires spectacles; this will cover all or part of the cost. At Boots Opticians we stock a special range of styles including some where the entire cost of both the frames and lenses is included in the Voucher value so no additional payment is required.

The Optician will explain the various choices that are open to you; for instance you may choose to use the Voucher to cover the cost of your child's lenses and simply pay for your chosen frame selected from the wide variety of styles and colours that we stock.

As with the eye examination, if new lenses are frequently prescribed due to changes in prescription, then the cost of the new lenses is covered by an additional Voucher - however frequently the change is recommended. Where the child is suitable, the value of the Voucher can also go towards part of the cost of the contact lenses for your child. In this instance the value of the Voucher is determined by the prescription. Our Optician will be happy to explain the various options that are available to you.

Care of Spectacles

If your child is prescribed spectacles then your Optician will carefully explain how to clean and care for them. Spectacles should always be clean and correctly fitted. If your child's spectacles become twisted or mis-shapen, they may become uncomfortable or affect your child's vision. If this happens you should bring them back and our Optician will check them for you and refit them if necessary, free of charge.

Some Questions and Answers

Do I have to pay for my child's eye examination?

No. If your child is under 16 years of age or under
19 and in full time education there is no charge.

When should I start taking my child to see the Optician?

From around the age of 3 or sooner if you have any
concerns about your child's eyes.

Does the examination hurt?

No. Normal eye examination causes no discomfort whatsoever to your child.
In a very small number of cases the Optometrist may have to administer eye drops which may sting slightly. However, parents would be consulted before this took place.

Can I accompany my child in the consulting room?

Yes. At Boots Opticians' e encourage parents, and even brothers and sisters, to sit in on the eye examination.

How can my child be examined if he cannot read?

The Optometrist can carry out an accurate eye examination on children or adults who cannot read or speak by using specially designed instruments in the test which do not require a response from the patient.

If I let my child wear spectacles when he is little, won't he become dependent upon them and always have to wear them?

No. Your child will only be prescribed spectacles if he has an optical condition that will benefit from them. This does not mean that the problem will remain with him for life. However, you cannot prevent or postpone the situation and by preventing your child from wearing glasses you may cause him additional discomfort.

Do I have to pay for my children's spectacles?

All children who are prescribed spectacles qualify for a NHS Voucher which may be used towards part or all of the cost of the spectacles. Alternatively, you may wish to use the Voucher to cover the cost of the lenses and choose a frame from the wide range available for children.

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Sources of help and information

Boots Opticians

Buy glasses, designer frames and contact lenses at Boots Opticians. Book an eye test online. Browse a wide range of glasses and frames.

NHS Live Well - Eye health

Includes contact lens safety, living with low vision, protecting your eyes from injury at home and work, and information about laser surgery.

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For Pupils

Use the link below to view the pupil material for this topic:

The information contained on this web site does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.