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Frequently asked question: what does my child see? A few vision simulators with caveats

July 28, 2014 Leave a comment

There’s a cliche of “looking through your eyes” as a way of trying to see the world as someone else might. It’s usually not meant literally, of course, but  it reflects our desire to understand how others see things. That’s certainly true when you learn that your child has a vision problem.  It’s very common to wonder how your child had been seeing.

what do you see4

Very young children don’t have the words to tell us what they want for dinner, let alone how they see.  Even older, more verbal kids have difficulty explaining how things look. It wasn’t until Zoe was 4 that she started telling me that things were fuzzy without her glasses. But the first time I really understood how she saw was after a trip to the science museum where she visited a human development exhibit.  They had glasses you could put on that approximated how babies’ vision develops in their first few months. “Mom, babies see really blurry they’re first month. Then at 2 months, they see the way I see without my glasses. By a year, they see how I see with glasses.”  Finally, I could put on glasses and see the world the way Zoe does with glasses.

If you can’t make it to a human development exhibit, there are quite a few online vision simulators that claim to let you see how another person sees, most are based on a person’s glasses prescription.  Of course, there are a lot of problems with even the best of these.  In fact:

A glasses prescription will not tell you exactly how a person sees

A glasses prescription will only tell you what shape the lenses on a pair of glasses or contacts should be in order to have the best possible corrected vision.  This is based on how much the shape of the eye differs from what it should be to see clearly (something called the refractive error).  Some (not all) of the reasons why someone may see differently than their glasses prescription implies include:

  • Hyperopic children can often compensate for much of their hyperopia, allowing them to see relatively clearly.  This does cause eye strain and can pull the eyes out of alignment, which is why glasses are still important.
  • Amblyopia is when a person does not see clearly even when glasses or contacts are correcting for the full refractive error.  Generally this is due to the brain suppressing the vision from one or both eyes.  It can be caused by the eyes not lining up, an eye having an injury, or one eye having a much stronger refractive error than the other.
  • There may be other problems in the visual system (either in the eye structures, the optic nerve, or the brain) that is causing vision problems.

One very simplified way of looking at it is imagining the visual system as a camera.  The lens of the camera may not be in focus, that’s the part that glasses can fix that.  But there are a lot of other components of the camera that may not be functioning correctly, and any one of them can lead to unclear vision.

Visual Acuity

The measurement that best describes how clearly a person sees is their visual acuity.  It is usually expressed as two numbers, like 20/20 or 6/6.  The first number tells you the distance at which the measurement was taken (20 or 10 is in feet, 6 or 3 is in meters).  The second number tells you how far away a person with good vision could be to see what you see clearly.

For example, the visual acuity of my left eye without glasses is around 20/200.  That means that what I see clearly at 20 feet away, a person with good vision would see clearly at 200 feet away.  (I do not see terribly well in that eye).  There’s a conversion chart here that converts between metric and US measurements as well as giving reading performance for those acuities.

If you’d like to see what a specific visual acuity looks like, there are a couple of options:

Wolfram Alpha will show you a simulation of any acuity you type in.  Simply type in the visual acuity with the word “vision”: in this case “20/200 vision” (if you don’t include the word “vision” it’ll just calculate the fraction for you).

20-200

Wolfram Alpha’s simulation of 20/200 visual acuity. I typed “20/200 vision” in the search box to get this.

Fork in the Road Low Vision Simulators are vision simulators that you can purchase and wear to see the effects of different eye diseases.  Their cataract simulators demonstrate reduced visual acuity.  On their website, you can see examples of the blur simulation for 20/80 (6/24), 20/200 (6/60), 20/400 (6/120), and 20/800 (6/240).  Scroll through the page to see the different acuities.

 Vision Simulators based on Prescription

As I mentioned, vision simulators based on a glasses prescription are flawed at best.   Even the very good ones will only show you an approximation of how someone with no other vision issues would see with that prescription.  That said, the simulators can give you a feel for how strong a prescription is and how your child might be seeing without glasses.

  • Eyeland Web Tools – there are different simulators for different refractive errors.  Many children have a spherical (hyperopia or myopia) component as well as an astigmatism component.  I like that these allow you to see how those different components affect vision.
  • Sehschärfen Simulator – this site is in German, but is still pretty straight forward to use.  One of the features is that it changes the simulation based on a person’s age, so that the effects of hyperopia (farsightedness / longsightedness) are reduced for young children.  This means if your child has a + prescription, you may think from this simulator that your child shouldn’t need glasses.  This simulator will not show you how much eye strain a child will have due to hyperopia.
    1. Enter your child’s age in the “Alter” box
    2. Enter the spherical and cylinder amounts
    3. Click “Berechnen”
    4. The top image is the simulated vision, the bottom image is what would be considered “normal” vision.

Other visual simulations of eye diseases

  • Fork in the Road sells vision simulators for many eye diseases resulting in low vision.  This includes cataracts (linked above), glaucoma, and more.
  • Inclusive Design Kit from the University of Cambridge also has a simulator for many vision problems.
  • Causes of Color includes a vision simulator for various types of color blindness and cataracts.

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My book is published

July 10, 2014 3 comments

I’ve posted a bit about the children’s book about glasses that I’ve been working on – it’s one that I held a Kickstarter project to raise the funding for.  Well I’m thrilled to say that the book has been published and is now available for purchase.  The whole experience has been fascinating, eye opening, way outside my comfort zone, but in the end, a really good experience. cover final The project was largely inspired by the comments I’d gotten on the photo gallery page.  I had figured the photo gallery would be great for parents to see the range of glasses available for kids, but I hadn’t expected that parents would show their kids the gallery, and that kids would feel better about their glasses after seeing other kids like them in glasses.  I also remember how much Zoe loved looking at books with pictures of kids, and I wanted her to see kids who wore glasses just like she did.  And I was also a bit sick of books that talked about kids who hated glasses or who were teased about their glasses.  Those are definitely good stories to have, but they didn’t reflect Zoe’s experiences at all.

After waiting for 5 years for someone else to write a book that featured photos of kids in glasses, I finally decided that I was going to have to do it.  And luckily, I knew that my friend Kristin from Peeps Eyewear was just as interested as I was in helping kids in glasses, and since she had published a children’s book, she knew a lot more about the process and had the contacts to actually make it work.  She agreed to be my publisher, for which I am so very thankful. I’m thankful, too, for so many of you who backed the Kickstarter or shared the project or gave me support (I wrote a bit about Kickstarter here and here).  I was able to get funding to cover most of the up front costs (photo shoot, graphic design, printing, etc). We held the photo shoot for the book in January.  The daycare center that my children attend was gracious enough to let us use their classroom (with fun colorful toys, and huge windows to let in the sunshine) for the photo shoot.

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Our photographer, Heide, was simply amazing.  She worked hard and had a fantastic rapport with the kids.  And the kids were all amazing, too!  It was honestly a lot of fun –  just watching these kids play and have fun, and watching Heide work her magic to get some amazing shots, and meeting the parents and hearing all about their stories. Then came more work – choosing photos, working with the graphic designer, trying to get the print run to be true to color, getting an ISBN for the book… all sorts of things that I had never, ever dealt with before, so again, I’m thankful for Kristin’s help.

It took longer than anyone of us had expected, especially since we had to not only produce the book, but also the other rewards for the Kickstarter backers.  But now I can hold all that hard work in my hands!

that's my hand...holding my book!

that’s my hand…holding my book!

I have to say one more huge thank you to all of you out there for your support and inspiration for this book.  I don’t know how I can thank you all enough.

 


Reader request: anyone with a child diagnosed with CHED?

Is there anyone out there with a child diagnosed with CHED (Congenital hereditary endothelial dystrophy), either recessive or dominant?   Another parent is really hoping to connect others facing the same thing, as it’s a rare disorder, their having trouble finding others out there.

Leave a comment, or drop me an email (ann@shinypebble.com) if you would like to connect.

 


Survey for US parents of blind or visually-impaired children

June 14, 2014 1 comment

Stephen sent the following:

Greetings,

I am visually impaired as are two of my daughters. I am also a firefighter and currently conducting research to see is blind and visually impaired persons are adequately taught education in fire prevention and life safety.

I am posing a link to survey for parents of blind and visually impaired persons. It is a Google Drive survey. I ask that you please take 10 minutes to complete it.

The goal is that my theory is supported and proves the need for education for VIP’s in fire prevention and life safety and hopefully provides the catalyst for change. I apologize, but only US residents feedback is needed as my focus of my research is in the US only.

Click here to take the survey

Children’s Eye Foundation 2014 photo contest – Best Buddies to See You Through

May 17, 2014 3 comments

It’s again time for the annual Children’s Eye Foundation photo contest for their calendar.  The Children’s Eye Foundation  is the foundation of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS).

Take a look at this year's calendar.

Take a look at the 2014 calendar.

The theme for this year’s photo contest is “Best Buddies to See You Through“.  Once you submit a photo, people can vote on their favorites.  The top 10 vote-getters will win a camera, and a panel of judges will choose from all submissions the photos that are featured in the calendar.  Voting is open until August 31, 2014.

A number of kids from our community are featured in the calendar each year (of course they are – our kids are super cute!).

Take a look at the full rules for the contest, and submit your photo.   If you do submit a photo, leave a comment here letting us know which photo you submitted.

You can also vote for your favorite photo!  You can vote for one photo once each day.

The third annual Great Glasses Play Day!

May 1, 2014 2 comments

The third annual Great Glasses Play Day is just around the corner!  I’ll be celebrating in Minneapolis, but there’s a whole lot of events this year and even if there are none near you, we have many ways for you to join the celebrations!

GGPD-infographic-2014

Many thanks to Jessica Butler of Eye Power Kid’s Wear for the graphic!

Great Glasses Play Day 2014 updates!

March 13, 2014 1 comment

We’re getting closer to this year’s Great Glasses Play Day – our 3rd annual event will happen the first weekend in May!

What’s the Great Glasses Play Day?

For anyone unfamiliar with the event, it’s a day to celebrate kids in glasses, patches, and contacts.  It’s a chance to meet up and have a good time and support one another.  And it’s a chance to raise awareness of the importance of catching and treating vision issues early.

From last year's Portland event!

A scene from last year’s Portland event!

We have locations around the world where volunteers help to organize meet-ups.  These often take place at parks or play areas.  Mostly it’s a chance for our kids to get together and make new friends.  We’ll provide organizers with flyers and materials for some of the activities, and we’ll help get the word out.

So where are the events?Ann Zawistoski's photo.

Check out the Great Glasses Play Day website to see the most up to date map.  We’re still in the planning phase, so you’ll want to check back for the full details.
Don’t see a location near you?  You can sign up to organize one in your area!
First, check out the map of all the events! This is still a tentative map, with more

T-shirts!

And the t-shirts for the day are available, too! Designed by Eye Power Kid’s Wear – proceeds from the sales will help cover some of the costs the come with throwing these events!  Order your shirt today!


Your stories: Growing up with congenital nystagmus

February 12, 2014 Leave a comment

I love sharing stories of people who grew up with glasses, I think it helps me to hear what their childhood were life.  I am so pleased that Nitie agreed to write about her experiences growing up with nystagmus.  Many, many thanks, Nitie! -Ann Z


Growing Up with Congenital Nystagmus

Nitie heas shotHello my name is Nitie Mehta and I have a 7 year old daughter. No she does not have Congenital Nystagmus but I do. I wanted to share with parents my experience of growing up with Congenital Nystagmus.

When Ann asked me to write about this I did not know where to start as there is so much I would like to share,  so I am  breaking this post into 3 sections

  1. Congenital Nystagmus: the way I see
  2. Only If I Knew This Before
  3. Adapting to everyday things

1)      Congenital Nystagmus: the way I see

Growing up I just thought I was a normal child just like any other kid. I only needed glasses to see well. To be honest I really did not know why I wore glasses because I did not see any different with or without them. Yes, unfortunately glasses do not correct too much, I improved from 20/80 to 20/70. That meant I could not read the black board in class and could not recognize someone across the playground. If the font was large (14) and there was plenty of light I could read but otherwise I would avoid reading and could never read more than 5 pages at once.  Once I was in 5th grade and school work had increased I started using a magnifying glass to help me read normal print. But all along I considered myself a normal child who needed to be a little closer to read.

2)      Only If I knew This Growing Up.

I grow up in India in the days prior to the internet. I really did not know much about my condition and I am not sure my parents knew too much too.

  • Ball sports that needed hand eye coordination or depth perception were not for me.  I spent 3 years learning tennis, only to hope and pray that I could somehow hit the ball back, because I really did not see it till it was over the net. Instead swimming, running, rollerblading, cycling would have been great sports to pick up.
  • I hated family movie nights: our television sets was not large and there was a myth that if you sit too close to the TV it spoils your eyes. Thus sitting 6 feet away from a 28 inch TV I could barely see anything. Only if I sat closer I would have enjoyed family movie night.
  • Good white light would make it easy for me to read. It was not until I was in 7th grade that I discovered that a nice bight white light lamp made things so much easier to read.
  • People often have a visual memory; they read something and have a visual image of it that they can remember forever. Well I did not have this but I do have an audio memory that is if I heard anything I would remember it.

3)      Adapting to Everyday things

  • Once I was a teenager I realized that there were things I could not do on my own even if I tried really hard, but what I could do was make good friends everywhere I go so they could help me.
  • Driving – not only do I have the GPS but also carry paper direction and if possible ask for land marks to a new place I am going, this way I do not need to read road signs or house number.
  • Reading menus at a fast food place or in a dimly lit restaurant: I always search for the menu online before going to a place and know what I am going to order. If for some reason I have not done this I ask the waitress for their special and just pick something from it.
  • Reading fine print on anything. I use my smart phone and take a picture of the thing and then enlarge it to read it.
  • Driving at night, I am not supposed to drive at night thus I will form a carpool group and offer to pay for gas if someone else is driving.

Finally parents of kids who may have this, I want to leave you with this, I have an MBA, I worked at KPMG Consulting a top 5 consulting firm and at Microsoft before I decided to start my own Eyewear company Taffy Eyewear . You child too will and can achieve anything they set out to do when you believe that they can.

Nitie Mehta is the founder of Taffy Eyewear: Eyeglasses specifically designed for kids


Book review: I See, You See, We ALL See!

February 10, 2014 2 comments

I seeI was thrilled to receive my copy of “I See, You See, We ALL See!” in the mail today.  This is a board book written by Allison Joyce and Don McClain, inspired by Allison’s daughter Emma.  Allison ran a Kickstarter this fall to raise the money to cover the production of the book, and the results are fantastic.

The book follows Emma and her big brother as Emma wakes up from her nap and gets ready to go play outside.  Her brother helps her remember all the things she needs: shoes, jacket, hat, mittens, but most importantly, her glasses!  The story line is simple, but it’s fun and engaging and very appropriate for toddlesr.  My 3 year old daughter (the one that doesn’t wear glasses), has asked to read this book multiple times, and loves “helping” Emma figure out what all she needs to wear.

20140209-211130.jpg

The illustrations by Amanda Beard are beautiful and fun and bright.  We spend quite a bit of time looking through the pictures to find all of Emma’s outdoor items.

There are practically no books that are targeted at very young children in glasses.  Allison’s book is a sturdy board book that’s going to stand up to the repeated readings that I’m sure will happen.  The story and illustrations are right on for the age group.

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Is it a good thing for glasses to be associated with geeks and nerds?

February 5, 2014 2 comments

Recently, UK retailer Tesco had some children’s shirts for sale that had a picture of an animal wearing glasses and the word “geek” or “nerd.”  Quite a few parents wrote on Tesco’s wall to complain about the shirts linking glasses with a term that many people still feel is an insult.  Tesco decided to remove those shirts, and you’d think that would be the end of that.  But some newspapers picked up the story, and chose one mother’s post in particular and wrote articles about how that one mother had forced Tesco to remove a line of clothing.  The story has taken off from there, though hardly any of the newspapers have bothered to talk with Aneliese, the mother whose post they cited, about any of it.  (I’m not linking to any of the articles because the reporting was so very shoddy).  Now I’m not new to the Internet, I know that people can be cruel and take things way out of context, but I’ve been horrified by the number of awful comments, tweets, and posts that Aneliese and her son have received due to this.  Inside the Wendy House has a good post that talks about what happened (and actually talked with Aneliese about the incident, as have I).

Tesco is not the first retailer to have shirts that show a character in glasses with the work “geek” or “nerd”, and I’m sure they won’t be the last.  The question shows up a lot in the Little Four Eyes facebook group.  It’s always leads to an interesting and spirited debate, and the community seems to be pretty evenly split on the issue.  On the one hand, as many parents point out, “geek” and “nerd” are no longer the insults that they used to be, in fact, they can be seen as cool and the words should be taken as compliments.  Any thing that portrays glasses as being cool, those parents say, is something we should celebrate.  Other parents note that “geek” and “nerd” may be cool for some, but they’re still a stereotype with specific associations that are not all positive, such as being introverted and socially awkward.  For those parents, glasses are something that help or at least protect, our children’s vision, they don’t define our children’s personalities, for better or for worse.

I hope everyone can agree that insulting a mother for giving a retailer feedback about their merchandise is completely uncalled for unnecessary, and frankly, really awful.

I should note that I consider myself a nerd (I’m not cool enough to be a geek), and that I’ve been nerdy all my life.  It wasn’t a label that I liked as a kid or in high school, but now 20-some years later, it’s a label that I will proudly wear.  I also wear glasses, but even when I wore contacts, I was quite a nerd.

I do think there are a lot of problems, though, with associating “geek” and “nerd” with wearing glasses.  I honestly cannot think of another personality stereotype (and let’s be honest, whether you see geek/nerd as good or bad, it’s a stereotype) that is associated with something that needs to be worn for medical reasons.  The need to wear glasses is almost always because of structural issues with the eye – this has nothing to do with a person’s intelligence or how well they do interacting with others.

It bothers me because while I’m happy with being labeled a nerd, I know plenty of people who would not be happy with that characterization.  Some of those people wear glasses.  I look at Zoe, and I wonder what she’ll want to be known as when she gets a bit older.  Will she want to be the nerdy girl?  Or will she want to be arty, or athletic, or will she want people to not label her at all?  Who she decides to be should not have anything to do with the fact that she’s hyperopic with moderate astigmatism.

On a less personal note, I have written before about the problems that can arise when children aren’t treated for vision issues.  I hear from a lot of parents when they first learn their child needs glasses, and many of those parents are filled with fears (I know I was).  Some of those fears have to do with general vision and glasses-related issues, but there’s also the fear that your child will be seen and treated differently once they have glasses.  Glasses for your child are hard enough to deal with, even without the fears, they’re expensive and frustrating.  I’d love to lessen any of the stress that comes with having a young child in glasses – that’s part of why I started this blog, and that’s part of what’s behind my dislike of the association of glasses and nerd/geekiness.  Why add to the potential reasons why a parent might not follow through and make sure their child needs glasses?  Not that I think this alone will solve the problem, but I don’t think it helps.

All that being said, there is a lot of evidence that the fears we have as parents of our child being treated differently or seen as less attractive because of their glasses are not always borne out.  I don’t want to dismiss anyone who has actually experienced their child being bullied or teased because of their glasses, but there have been studies that have found that glasses really aren’t seen as a bad thing by other kids:

  • One study asked kids in glasses and their parents a series of questions about their quality of life including socially.  It asked the kids questions like “are you teased because of your eyes?”  And it asked parents questions like, “do people treat your child differently because of his or her vision?”  The kids’ answers were the same as other kids their age without glasses.  They did not report being teased because of their glasses.  The parents on the other hand were very worried about their child being treated poorly.
  • Another study had kids look at pictures of other kids, some with glasses, some without, and asked which kids they’d rather play with, and which ones were the most honest, or smart, or better looking, or better at sports.  According to that study, there was no difference in how kids saw other kids in glasses, except that they thought they looked smarter.

Essentially, what our kids experience because of their glasses is probably not as bad as we worry about.

So what do you think?  Is it a good thing that glasses are associated with the newly cool nerd and geek identities?  Or is it something that bothers you?  (I don’t think I need to add this, but please be kind in your comments, I think this is one of those topics where people can disagree with very good reasons on all sides of the issue).


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