Every parent at one time or another will ask this question of their pediatrician or their eye care professional (ECP) whether it is an optometrist or an ophthalmologist. Myths abound and opinions are strong. For years the answer was an emphatic “no”. New research in the last ten years have begun to shed light on this question although it will unlikely answer all of the questions that parents ask.
My review of the literature and recent attendance at conference suggests a two pronged approach to the retardation of refractive error progression. One is “passive” and the other “active”.
Between the ages of five and ten, “emmetropization”, a natural biological event, will occur and “correct” minor refractive errors. What th is means is the body itself will adjust minor refractive errors all by itself without the need for lenses. To promote this phenomenon, distance vision activities such as outdoor sports or walks of one to two hours are beneficial.
The fitting of corrective lenses in this time period must be judicious with their premature use actually promoting refractive error progression rather than minimizing it. Of course, high amounts of refractive error will require correction because emmetropization only corrects small amounts of refractive error.
In the latter, or active approach, prescription lenses are given counter the eye’s exposure to hours of reading and computer use. Prolonged near task prevents the eye from readjusting the focus for distance. The eye embeds this distance as the best distance it can see making the eyer near sightedness or myopic. Lenses can relieve this permanence.
I recommend that 5-6 year old children incorporate a daily, hour-long outdoor activity of distance vision tasks to prevent fixing the eye to focus only at short distance. I also feel that correction of minor refractive error be deferred as long as practical. At age 8-10, if there is significant refractive error, progressive addition spectacle lenses or rigid contact lenses to modify the surface geometry of the eye should be considered.
In summary, there are alternatives to a child’s vision. In the course of your child’s eye examination, a discussion of these options with your ECP may be fruitful.
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