UAB Medicine News
End-of-Summer and Back-to-School Eye Safety
August is Children’s Eye Health and Safety Month, which emphasizes healthy vision for children by encouraging eye examinations to detect vision problems, and by preventing eye injuries at home and at school.
During the first two weeks of August, the seasonal risks of children’s eye injuries tend to overlap. Many kids who still have all day to play will spend time at the pool, the beach, or the ball field. When school starts, some of the youngest students will be using scissors, pencils, and glue for the first time, or joining rowdy classmates on a new playground. Older kids may be signing up for sports teams. Although the number of eye injuries among the pediatric population peaks in midsummer and declines somewhat in early fall, it is a good idea to proactively think in terms of safety.
Prevention is the Best Cure
In the United States, sports-related injuries are the leading cause of blindness in children. The good news is that 90 percent of sports-related eye injuries can be prevented by protective eyewear, says Martin S. Cogen, MD, Pediatric Ophthalmology & Strabismus Professor, UAB Department of Ophthalmology. “Everyone’s heard the old saying that an ounce of prevention is worth a pound of cure. Well, it only takes a second to put on a pair of safety goggles, but it could take years to rehabilitate an injured eye," Cogen says.
Regular eyeglasses do not offer the impact resistance that polycarbonate sports eyewear provides. In some instances, eyeglasses and contact lenses may create a greater risk of sports injury. Because few youth sports organizations mandate the use of safety shields, safety glasses or goggles, or eye guards, it is left up to parents and coaches to urge children to use these devices when they engage in sports. Outdoor outfitters and sporting goods store offer a variety of approved protective eyewear.
Activities at the pool and beach bring several eye safety and long-term vision health concerns. At home, it’s important to maintain your pool’s proper pH levels to avoid irritation from pool cleaning chemicals. If kids are planning to spend a lot of time under pool or salt water, goggles provide some barrier to irritation. Roughhousing in a crowded pool leads to a large number of eye trauma incidents among children each year. Careless play with some pool toys, such as flying discs, foam bats, or balls that soak up a large mass of water, can cause trauma injuries as well. Keep the “battles” and other rough play to a minimum, especially if older kids and the little ones are playing together.
A key concern at the beach, lake, or pool is exposure to ultraviolet radiation (UV). Because a child’s lens has not fully matured, it cannot filter out UV rays as efficiently as an adult’s lens can, therefore a child’s retina may receive up to three times the seasonal radiation mature retinas are exposed to. Consistent exposure at such levels can lead to serious vision impairment in later years. Protect kids’ eyes from UV rays by making certain they wear sunglasses that filter both UVA and UVB rays. Remember that beach umbrellas, shaded areas, and ball caps do not fully protect eyes from UV rays reflected from water, sand, or poolside surfaces.
Once the school year begins, most children are under stricter supervision in the classrooms and on the playgrounds, but certain risks of eye injury still arise in those settings. As noted above, kids who join sports teams can most easily avoid injury by using protective eyewear. During recess, however, a new group of excited kindergarteners and first-graders may forget anything they’ve previously learned about flying swing seats, softballs, or running with pencils. There’s also the temptation to impress all those new peers by taking extra risks. Before the first day of school, talk to your child about establishing a line between showing off and having fun on the playground or in the gym.
Among the five most common causes of children’s eye injury are exposure to harmful chemicals and the misuse of tools. Arts and crafts don’t pose much risk in the classroom, where child-safe scissors, glues, and paints are mandatory. However, a large percentage of injuries occur in the home as a result of art projects gone wrong. Children who return from school with a new interest in arts and crafts (or a project due) may look around the house or garage for paints, glue, and clean-up products. Make certain your child knows that all home projects require adult supervision. If there are children five years old or younger in the family, then store all chemicals and dangerous products in locked cabinets.
Another eye-safety issue that gets little attention, but is worth noting, concerns travel to and from school. Too many times, in a vehicle in which the toddler is safely secured in a car seat and the older kids are under seatbelts in the back seat, there remain numerous toys, lunchboxes, pens, water bottles, and other objects that become projectiles during a crash or an extremely abrupt stop. Make sure your entire car or van is a safe environment before transporting children.
Early Detection Saves Vision
Although many school systems require eye examinations for students early in the year, your child's eyes should be examined during regular pediatric appointments, and vision tests can begin at age three. It’s a good idea to have your child’s vision checked before school starts. Doing so may provide a head start on getting fitted for eyeglasses, but early detection of serious conditions is equally important.
Astigmatism is a naturally occurring, treatable condition of the eye that causes blurred or distorted vision. Most people have it to some degree, but children may not recognize the symptoms. If left untreated, astigmatism in one eye can cause amblyopia, the most common vision impairment in children.
Commonly known as "lazy eye,” amblyopia is marked by reduced vision in one eye. The condition usually begins when the weaker eye, though it may appear normal, is not able to focus as well as the other, causing the brain to favor the stronger eye. Amblyopia almost always is detectable before age six, and because connections between the eye and brain are formed in childhood, so early diagnosis and treatment is important.
Strabismus, or crossed eyes, is a condition that causes the eyes not to line up in the same direction or look at the same place at the same time. Though strabismus can be a result of severe farsightedness, it usually is caused by poor eye muscle control. Strabismus typically develops in infants and young children by age three, and most adults who have the condition have had it since childhood.
Watch for signs that suggest a condition is present or is developing. Squinting while writing or watching television, a sudden lack of interest in reading, or crossing eyes may be indicators. Talk to your family’s pediatrician if you suspect your child has nearsightedness, farsightedness, or astigmatism.
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