It is a shock to find out that one’s small child can’t see properly. I somehow thought because children are still small their eyes should be very good. Well, actually I didn’t give it much thought at all. Until it happened.
The trouble is, children don’t know what things should look like. Or, if their vision deteriorated gradually, they forget. So they DO NOT COMPLAIN of bad eyesight. They might blink a lot. (Which, incidentally, also might point to a vitamin A deficiency or uptake problem). They may sit too close to the TV. They may develop a squint. They may become less attentive of their environment. They may stop paying attention in school. Their art work may not be the best – which sometimes it isn’t in any case. They may seem bored or unmotivated. In children depression can look like boredom. And it surely is depressing when one can’t see. They may seem anxious and unsure. They may suddenly fall down a lot or become car sick. And parents may very well overlook all these subtleties. Teachers too.
So well done if you realized your child has a vision problem. That was some great parenting right there! And if you are looking around for more help, even better. This is the list I wish I had. If someone could sit me down in the very beginning and say, “Listen, here’s what you do:…,” we would have had a much easier time. But when everything turns out ok, luckily we tend to forget a lot of those pesky little details. Remember that the whole body is one unit. Vision is a function of every single part of a child. This will hopefully demonstrate that. So here is my two cents’ worth:
STEP 1: Have your child’s eyes tested. Find the best ophthalmologist or optometrist by reputation. It is very very difficult to get a child into their ideal glasses prescription. And they may refuse to wear it, because of the big change it creates. Work with the professionals to find the prescription that your child can tolerate initially. It can be adapted once they get used to it.
STEP 2: While you are waiting for your eye appointment, start looking at frames. The optometrist’s is a good place to go. They should be small enough so the lenses don’t have to be too thick. And very sturdy for playing and rough housing in. Get your kid excited about these glasses – even though you are still struggling with the idea.
STEP 3: Get support. Yes, it helps to see you are not alone. And to ask all those many many questions. Two wonderfully useful Facebook groups are: Little Four Eyes and: Vision Therapy Parents Unite. Vision therapy is an option in some countries.
STEP 4: Have a developmental occupational therapy assessment. If your child could not see properly for however long, they are sure to need a little bit of developmental input. The occupational therapist will look at things like vestibular and proprioception or tactile issues. They will also test for gross and fine motor delays. These skills are the foundation for school skills later on. Visual-motor perception and motor planning is greatly affected by faulty vision.
STEP 5: Young children with vision problems often have retained primitive reflexes. These reflexes create movement patterns in babies before they do conscious, controlled movements. When the higher postural reflexes start taking over as babies mature, the primitive reflexes disappear. They may reappear as a result of physical stress (like lack of vision). Or they may have been retained because of lack of tummy time and movement opportunities as a baby. To check, look at a photo of your smiling child. If they have wide, staring eyes even when smiling, they may have a raging retained Moro reflex. Some paediatric physiotherapists, occupational therapists and behavioural optometrists address these reflexes and help integrate them. It is a long term process that requires dedication and daily effort, but it pays off big time. Retained reflexes interfere with vision development, gross and fine motor skills, hand-eye coordination and general school performance.
STEP 6: Inform your child’s teacher. Getting glasses is a transition. This child might have a hard time adjusting and coping. Kindness and gentle encouragement is needed. Keep the expectations at a minimum for a while and everyone will be happy.
STEP 7: This one should actually be the cornerstone of every step. Lots of love for this brave child. Patience, love, acceptance. Your child is going to be facing hard changes. Lots of challenges. They need you on their team. Loving them, cheering for every little step forward, carrying them sometimes. Your job as a parent is to know when your child needs a break.
STEP 8: Limit screen time. Too much screen time interferes with developmental movement opportunities of body and eyes.
STEP 9: Get moving, get active, get outside. Studies have shown outdoor activity has a positive impact on vision development. Work those core muscles. Head control and core stability has an effect on eye convergence. Very important for children with amblyopia (lazy eye). Ball sports are lovely and fun for improving eye tracking.
“Sucking on Sour Candies, Pickles or Lemon Pieces. Sour tastes help bring facial muscles and eyes into a more focused (aimed inward) state, called convergence. Sucking helps to bring the facial muscles, including eye muscles, into a convergent posture…After sucking on a sour food or piece of candy, encourage the child to attempt a near-vision task that was difficult for him previously, and see what happens!” – Quote courtesy of the book Eyegames: Easy and fun visual exercises by Lois Hickman and Rebecca E. Hutchins.
STEP 11: Sagging arches in the feet may affect vision development. Arch support is directly linked to eye convergence. The lumbrical muscles in the feet are responsible for arch support. They work in synergy with all the postural muscles. For children older than five with flat feet orthotics can be investigated. The physiotherapist can recommend a good orthotist to custom make these. Lumbrical exercises for feet are easy. It has been suggested that toe walking may improve the arch support in flat feet. Invest in good shoes that keep little feet more optimally aligned.
STEP 12: Reawaken the senses. You know how some people feel like they don’t hear/connect well without their glasses on? Same goes double for children. Not being able to see well does not sharpen the other senses. Rather it dulls them. With muted senses a child’s world becomes small. And they do less of the very activities that would have helped them. Practicing mindfulness on nature walks is a lovely way to help a child with visual neglect to reconnect. This could be a walk around the garden. Smells in particular raise a child’s level of awareness. Probably because the olfactory and limbic system, where emotions are seated, are enmeshed. Vestibular input helps restore proper eye movements, so running, rolling, swinging.
Enjoy this special time of rediscovering sight with your child.