Although most adults at some time seek help to correct or improve their eyesight, it is still relatively rare to see young children wearing glasses. But this does not mean that most children have perfect eyesight. Sadly, many are just unaware that a problem exists.
It is estimated that one in every five schoolchildren has an undetected eye problem and, as so much learning occurs visually, this can have a significant effect on their reading and general learning, not to mention reducing confidence and causing headaches.
Early detection, preferably before the age of seven or eight, while the muscles, focus and co-ordination of the eyes are still developing, can help to alleviate these difficulties in the long term. Most symptoms can be greatly improved, and sometimes eradicated, with the help of an eye patch or spectacles.
Some conditions, such as 'lazy eye', can become permanent disabilities if they are not treated early, so it's well worth promoting good eye health and regular testing. Look out for any potential problems that a parent may not have noticed or is reluctant to acknowledge.
Early signs
Some eye problems are relatively easy to recognise. A squint or a drooping eyelid, for example, is usually picked up quickly by a family member or health visitor. Poor vision may not be so readily identified, especially in a baby or toddler who is unaware, or unable to tell you, that they cannot see as well as others do. So, what can you do to spot the early signs?
Harsh Shah, a practising optometrist and chairman of the Hillingdon Local Optical Committee, says, 'Typical warning signs that something may be wrong include excessive blinking, peering closely at books, TV or computer screens, squinting or screwing up the eyes in an attempt to see more clearly, poor hand-eye co-ordination, or just generally bumping into things they haven't noticed are there. It's easy to think that a child is just clumsy, and it is often grandparents, carers or those less close to the child who realise there is an eyesight problem before a parent does.'
Annual eye tests are advisable for all children, from as young as one year old, and certainly by the age of three. They are recommended when a defect such as astigmatism, short- or long-sightedness or squints are already present in the family.
Because they are NHS funded, the tests are free, and help is available towards the cost of lenses and frames, even if they need to be replaced regularly as the child grows or their prescription changes.
'Good vision is essential in childhood development, and regular eye examinations are the key to good vision, even if nothing obvious appears to be wrong,' says Mr Shah. During a recent visit to a reception class he found that more than 60 per cent of the children had never had an eye test.
Many parents fail to realise that eye tests are necessary, or believe they are impossible until a child is able to talk and read letters from a traditional chart. But simple picture recognition methods and specialist equipment at hospital clinics now enable accurate assessment and monitoring of the condition of a child's eyes. All tests are carried out in an unthreatening and fun way.
Wearing glasses
What should you do when a child in your care has to wear glasses for the first time? First of all, be guided by the parent. They will know just how much the child understands about the need to wear, and care for, their new specs.
'It is surprising just how adaptable young children are to new experiences. The younger the child, the more readily they adapt,' says Mr Shah. Once children realise how much better they are able to see, they will likely wear their glasses with pride, especially if they look good and fit well.
For those who can't, or won't, keep them on, help is at hand. Modern plastic or polycarbonate lenses and special coatings reduce the chance of breakage or scratching. Special hooks can wrap around the ears to prevent glasses falling off, and flexible frames make accidental or even deliberate bending and breaking virtually impossible. It's wise to keep a second pair on standby in case the regular set needs to be repaired.
There will be times when a child will need to take their glasses off for safety and/or practical reasons, such as during boisterous or messy play. Providing a regular and safe place for them to be stored, out of reach of the other children and where the owner will always know where to find them, is essential. It will also serve to integrate the care of the glasses into the child's daily routine.
Some young children may even be prescribed contact lenses if these are considered the best practical or vision-improvement option, and again close co-operation between parent and nursery staff will ensure there is always someone available who knows how to remove, clean and replace them in a child's eyes when necessary. No matter how independent the child may want to be, glasses and contact lenses are valuable and fragile, and any care regime will almost always need adult intervention or supervision.
Inclusion
What about the reactions of other children? When a child wears glasses or an eye patch for the first time, it is bound to attract curiosity and comment from their classmates. This can be upsetting for the specs wearer, who suddenly finds themselves the centre of attention.
This is a time to talk to all the children about feelings and how unkind comments can feel, and explain what is going to happen in advance, so that all are prepared for their friend's new look. It also helps to introduce props into the 'dressing-up' box, giving the whole group the chance to try on some 'dummy' glasses or sunglasses and admire their reflections in the mirror. Or you might use glasses to decorate a Mr Potato Head toy or when dressing a doll or teddy.
Look out, too, for picture books that show characters in glasses (see Resources). Anything you can do to promote a positive image of glasses will count to boost the wearer's self-confidence and gain the acceptance of others.
Resources:
Mr Potato head accessories sets, including glasses, are available from £3.99 from Playskool. (www.hasbro.com/playskool).
The Build-a-Bear Workshop (www.buildabear.co.uk) offers several teddy-sized pairs of glasses at £3.50 each.
What Can Rabbit See? by Lucy Cousins (Walker Books, £4.99) - this lift-the-flap book features a rabbit who 'wears spectacles so he can see well' and follows him as he looks at insects in the grass, fish in a pond, and stars in the night sky, ending with him going to sleep with the glasses safely on a table beside his bed.
All Kinds of Feelings by Emma Brownjohn (Tango Books, £9.99) explores how children feel about a range of experiences, including wearing glasses. This title is a Bookstart inclusive books recommendation and is also available in several dual-language editions.
CASE STUDY: MIA
Mia has a birthmark on her lip, so doctors assumed that a small growth found inside her right eyelid when she was six months old was a harmless birthmark too. In fact, following referrals to a plastic surgeon and the eye clinic at Great Ormond Street Hospital, it was found that the growth was putting pressure on her eye and weakening the muscles, which in turn was affecting her vision.
At first, Mia wore an eye patch for part of each day. She was given her first glasses when she was two and a half. The enormous improvement in her vision means that Mia has readily accepted her specs and wants to wear them, especially as she chose the current lilac-coloured ones (her fourth pair) herself.
She keeps them in a special safe place (on the mantelpiece at home and on the windowsill at nursery) on the rare occasions when she takes them off, and always asks for them when she wakes up in the morning.
Gill, the inclusion co-ordinator at the Little Handprints Pre-School which Mia attended in Hayes, ensured that Mia's glasses were always viewed in a positive way, so she was never made to feel different, even though she was the only child in a nursery of 30 children to wear them.
It was, in fact, Mia's original eye patch that aroused far more curiosity than the glasses. But both were soon accepted as the norm, and Mia is now moving on to a school nursery class of more than 40 children where she will again be the only one wearing glasses.
Viv Hampshire is a library outreach worker for Sure Start Townfield in Hillingdon, London.
