Myth busting with Kids’ Eyes Online
There are a lot of misconceptions out there about children’s vision and glasses for young kids. Here are the seven myths I’ve heard and read the most (and likely you’ve heard some of them, too) about young children with glasses.
- Babies don’t need glasses because they don’t need to read.
- You can’t test a baby’s vision, because they’re pre-verbal.
- You can’t test a preschooler’s vision, because they don’t understand the questions, and they’re just answering to make you happy.
- My toddler has no problem seeing small details in books, so there’s no way she could need glasses.
- A baby or toddler will never wear glasses.
- A child will wear glasses happily if they need them.
- Glasses will make a child’s vision worse, or will make your child dependent on glasses for life.
Monica Wright, the orthoptist behind the wonderful site, Kids’ Eyes Online, and I worked together to tackle these. I’ve linked to her answers after each of mine. Read on for the myths and our responses.
While it’s true that your 9 month old is probably not reading classic novels just yet (or even short stories), she is still exploring and learning about the world around her. We are very visual creatures, and much of our learning is done through seeing. Many parents whose children have visual deficits have noticed that their child may be slower to reach some of the developmental milestones such as walking, talking, and engaging in books. When that child’s vision is corrected, they often catch up extremely quickly. Take a look at this video of baby Grant – he had cataracts removed as an infant, and is getting glasses for the first time.
Now tell me that Grant didn’t need glasses. (You can read Grant’s story here.)
Furthermore, while reading may not come for a few more years (or more), there are a lot of pre-literacy building blocks that are being developed at a very young age. Things like recognizing that these funny lines on a page that are words with meaning, and being able to distinguish the individual letters and words. There’s a fantastic article about all of the foundational concepts that are necessary before a child begins to read. Take a look at the list and notice how many of those concepts are vision related.
Zoe was 9 months old when she had her first vision exam. She was not talking at all at that point. I really had no idea how they would test her vision. Her vision exams were quite different from mine, but her eye doctor was still able to assess her vision quite well. In Zoe’s exams, they used “preferential looking”: the doctor showed Zoe cards that were grey with a square of black and white lines (“Teller acuity cards”). The doctor watched to see if Zoe would look longer at the square, and then showed her more cards where the lines got thinner and thinner until even I could hardly distinguish the square from the surrounding grey. That gave the doctor an idea of how well she was seeing.
There’s also a test called Visual Evoked Potential (which I’ve never seen in person) in which electrodes are placed on the child’s head and used to detect whether the brain is responding to images on a screen. This can be especially helpful in cases where the child (or other patients) don’t do well with other tests.
Beyond those tests, eye doctors will dilate a child’s eyes and then examine it to see the shape of the eye, which is what determines whether a child is nearsighted (shortsighted), farsighted (longsighted), or has an astigmatism. This video does a great job of showing how that part of the exam is done.
3. You can’t test a preschooler’s vision, because they don’t understand the questions, and they’re just answering to make you happy
If you ask most adults about what happens at an eye exams, they’ll probably tell you about the frustrating part where you’re shown images and asked “which is better, one or two?” And then asked that again and again. Now imagine a three year old cooperating with that part of the eye exam and you can see where this myth comes from.
When Zoe was old enough to talk, they moved to an exam where she identified shapes on an eye chart (Lea shapes, in her case). She didn’t have to do the “which is better, one or two?” exam until she was 6 years old, and even then, it was only one part of the exam. They still have her read an eye chart and dilate her eyes as above to get a clear picture of her vision.
4. My toddler has no problem seeing small details in books, so there’s no way she could need glasses.
This may be the most common myth, it’s very common to want to be sure that your child needs glasses, and to look for obvious evidence that they’re not seeing well, especially when they’re not able to talk about how they’re seeing. I know I was confused as to how Zoe would still point out small details in books or find small pieces of lint without her glasses. The thing is, farsighted children can still focus quite well – they use something called their accommodative reflex. The problem is that this causes eyestrain, fatigue and can cause their eyes to cross (Zoe’s crossed a lot). I was finally convinced of her need for glasses when we had to send her glasses in for repair for a few days and she was exhausted for those days. Now that she’s older, she tells me that she needs her glasses to see well.
Another common thing is for one eye to see much worse that the other. The brain will just ignore the weaker eye in order to see better. That was my problem when I was a child, I had no idea that I wasn’t seeing well, even though when I finally got in for an eye exam, I could only just make out the big E on the eye chart with my right eye.
I would offer our photo gallery as evidence against this particular myth.
The truth is, it can be very hard to get a young child to wear glasses, but nearly all children will wear glasses eventually, especially if they help them to see, if the glasses are adjusted correctly, and if you are consistent about putting the glasses back on.
This is the flip side of the previous myth. It’s partly true, but I wanted to include it, because I do hear people say that if a child needs glasses, they’ll take to them right away and wear them. While that is the case for some children (lucky, lucky parents!), it isn’t always true, and I don’t want anyone to think that their child rejecting their glasses at first means they don’t need their glasses. Some kids are very sensitive to having something on their face, many others will take their glasses off whenever they’re bored, or the glasses don’t fit well, or the child is just in the toddler years and not being very cooperative.
I did a poll about a year ago about how quickly kids took to their glasses. Nearly 200 people responded. Not quite half (46%) of kids took to their glasses right away. More than 20% of kids took more than 2 weeks before they wore their glasses reliably. Staying consistent and positive, and putting the glasses back on every time they come off, is the best way to help a child get used to glasses. But it can still take a while before they’ll leave the glasses on.
Some children will outgrow farsightedness as they get older, though most kids in glasses will continue to need some kind of vision correction. Glasses do not cure a child’s eyesight (or an adult’s for that matter), but they will ensure that your child sees clearly and that their vision develops correctly.
“Glasses DO NOT cause dependence….just like shoes do not make your feet dependent upon them… Both shoes and glasses make it easier to do what needs to be done… See or walk. I want all my patients to see the best they can.”
Many thanks to Monica for help with the mythbusting!