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Ng Wing On Henry MSc in Optometry

BSc (Hons) Optom

Outline

1. Introduction - Pediatric developmental problems

2. Trend of refractive error

3. Genetic factors

4. Environmental factors

Impacts of technology

5. Protective factors

6. Conclusion

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Pediatric development – abnormal signs

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Critical period – Before Age 8

Abnormal sign:

1. Head tilt

2. Squeeze eyes

3. Eye turn in/out

4. Read too close

5. …..

Tentative diagnosis:

1. Amblyopia

2. Refractive error

3. Strabismus

4. Other functional problems…

5

6

4/8

(6/12)

Tentative diagnosis:

1. Amblyopia

2. Refractive error

3. Strabismus

4. Other functional problems…

Professional examination starts from…..

7

Age 3-4

Prevalence of myopia in two decades

8

Myopia > -6.00 D

Negative impact:

Cataract (白內障), Retinal degeneration (視網膜退化), Glaucoma (青光眼), Maculopathy (黃斑病變)…..

Myopia changes of preschoolers (age 2-6) in 10 years

2.3

6.3

0

2

4

6

8

10

Strabismus Myopia Hyperopia Astigmatism

96-97 06-07

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Environmental factors

1. Higher urbanization level

2. Higher education level

3. Prolonged near work

4. Reading material

Printed material (hard copy)

Visual display terminal or electronic screen (portable / desktop)

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Printed material

Electronic screen

13

14

Computer Vision Syndrome (CVS) 電腦視覺綜合症

According to the American Optometry Association 1995, CVS is defined as ‘‘the complex of eye and vision problems related to near work which are experienced during or related to computer use’’.

CVS symptoms

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• Dry eyes

• Red eyes

• Burning

• Tearing

• Itching

Eye-related

• Headaches

• Eyestain

• Double vision

• Blurry vision

Vision-related • Neck

• Back

• Shoulder

• Wrist

• Arm

Posture-related

Long-term effects:

1. Increase myopia

2. Dry-eye syndrome

3. Visual functional impair

4. Musculoskeletal injuries

5. ……

64–90% predominant visual-complaint

Computer screen

Computer room

Human eyes

Computer user

Computer task

Computer screen distance at least 20 inches away

Viewing angle of computer around 15 lower than

the horizontal level

The 20/20/20 rule

Screen lighting and room lighting / condition

Computer users should have a good sitting position

Corrective lenses

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Management of CVS

• Parents

• Teachers

• Professionals

• Hardware

Facilities, e.g. lighting, glare or computer setting

Electronic devices quality and quantity….

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Kid

s

• Lower self-awareness and self-management capabilities

• Not understand discomfort or other symptoms and lack an ability to report

• Lack an idea of proper viewing distance

• Weak in time control

Protective factors

• Outdoor activities

independent from near work and parent myopia

involve light-stimulated release of dopamine (多巴胺) from the retina

• Oral supplementation

Essential fatty acids such as omega-3 and omega-6 may increase the tear film lipid layer and reduce tear evaporation

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Protective factors

• Herbal medicine

massage or eyeball exercise

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Conclusion

• Role of kindergarten teachers in vision screening

• Professional follow-up (critical period – before age 8)

• Application of information technology in preschools

Administrators – hardware, teacher & parent education

Teachers – time control, posture….

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