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Top Ten New Years Resolutions for Screen time and Kids Eyes

(Note – You can read my previous Top Ten New Year’s Resolutions for Healthy Vision for Eye Health, Children’s Vision, Saving Money on Eyecare, Myopia Control, and Computer Vision Syndrome, -Dr. Nate)

Did your child receive any gifts with screens this holiday season? Or gifts such as a movie or new video game that are viewed on screens? My kids did. And they are VERY excited about them. They are not alone. The kids that I see in my office beg, whine, wheedle, and cajole their parents into as much screen time as possible. Many of them have their own tablets. And this is incredibly common. In fact, one 2015 study found that three quarters of 4 year-olds had their own devices.

There are obvious benefits for children to use technology. They can watch educational programming, Skype with distant friends and relatives, and download STEM and creative apps. But all of this screen time can come with downsides. One is childhood obesity. Another is social awareness and skill.

Others problem associated with screen time have to do with vision. This is something I talk about all day, every day at Bright Eyes Kids. Increased screen time can put children at risk for myopia (nearsightedness). Games such as Minecraft can be great, but can cause headaches and blurry vision due to eyestrain. In fact, eyestrain from device use can actually contribute to digital eyestrain or other visual problems that can make school work more difficult and require vision therapy to treat.

10 ways to keep your child’s electronic device use healthy:

  1. Set a clear Family Media Use Plan. For example, in my house, my children are not allowed screen time before noon. It is worth reading the American Academy of Pediatrics statement on media use from October 2016 to get some ideas.
  2. Optometrists recommend that people of all ages limit screen time to 20 minute intervals. Teach your child about the 202020 rule, every 20 minutes, take a 20 second break, and focus on something 20 feet away. Every hour, take a longer break.
  3. Buy a blue light reducing screen protector for your child’s phone, computer or tablet. http://health-e.com/offers one that reduces by 30%, but they offer through select optometrists 60% reduction.
  4. Mitigate the potential damage of focusing on close images, by having your child spend 2 hours a day outside. A recent study showed a 2% reduction of Myopia progression for every hour a week spent outside, or 28% for 2 hours a day.
  5. Minimize electronic device usage at night, a recent Harvard study showed that blue light at night effects melatonin levels, which effect sleep, blood sugar levels, and may be linked to certain other diseases.
  6. Ask your doctor about computer glasses or contacts which are specially designed to reduce eye strain by reducing the visual focus needed for computer use.
  7. Create fun alternatives to electronic devices, write a list of “cool” activities to do throughout the week. Great alternatives are outdoor time, board games, and creative projects. Even things as simple as walking to grocery store can be more rewarding than most things are your child’s screen.
  8. Role model proper screen use. As always our children learn from us, if we are glued to the screen, they will be less likely to take screen limitations seriously. Make a New Year’s resolution to limit your screen time and be more present for your kids. This is hard, but important!
  9. Make sure your child’s posture is not being affected by the chair or couch they are using while watching TV or on the computer. Adolescents with high computer usage were nearly twice as likely to report neck and back pain than those with moderate use.
  10. Talk to your eye doctor if your child avoids using the computer or complains about blurred vision or eye fatigue when using a screen, as this may signify a larger issue that needs to be addressed.

Happy New Year. May 2017 be better than 2016. 🙂

-Dr. Nate

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For Homeschool Educators

1172548_10150392203379977_1539208274_oMany of our patients homeschool. It is a special opportunity to help a child learn. It may also come with certain specific visual challenges. This guide and checklist below are tools that can help you identify visual problems that may be interfering with your child’s academic performance or making schoolwork more difficult.

Why is homeschool different?

Visually, homeschool can be different for two reasons. First, can be eyestrain. If homeschoolers spend much more time reading books and using technology such as laptops or iPads than students in the traditional classroom setting, this close work can put them at much higher risk for visual fatigue, and other visual problems.

Second, some students have developmental eye movement and focusing problems that is making learning to read more difficult. As a homeschool educator, you have a unique opportunity to keenly observe your child’s visual behaviors while they are doing schoolwork. Some parents notice unusual visual behaviors like head tilting in young children. But some symptoms like finger guiding and slow reading are expected in children under age 7.

But as your child progresses, you may notice symptoms on the checklist affecting your child’s confidence in reading and schoolwork. Some children enter 1st grade with high readiness scores, do well the first few years, and then collapse academically in the 4th or 5th grade. Sometimes this can be attributed to an undiagnosed vision problem that shows up when the child faces more visually demanding assignments.

In addition, visual performance deficiencies often go unrecognized in brighter children. This is in part because they use compensation skills very well. We see symptoms such as unusually slow reading, skipping lines, or avoidance of reading aloud that may not be apparent at first. This may become more noticeable after a child switches from “learning to read” to “reading to learn.”

Vision is more than 20/20!

Even if someone can see small letters on a chart 20 feet away, it doesn’t mean they have the visual skills needed to easily and comfortably read, play sports, use computers, or even see 3-D movies!

Many children with 20/20 eyesight (with or without glasses) may still have vision problems that affect learning, such as poor eye movement skills, difficulty focusing, poor eye-hand coordination, or lack of visual form perception.

Dr. Bonilla-Warford and Dr. Knighton evaluate a variety of visual skills in children and adults. These include:hero-visontherapy

  • Eye Movement Skills: Skills like tracking words across a page or following a ball across a field can make reading and sports challenging.
  • Eye Teaming Skills: Using both eyes together is essential for clear vision when reading. When eyes do not team accurately, a child may experience double or blurry vision.
  • Eye Focus Control: The inability to change focus quickly and accurately at all distances can lead to eye fatigue and headaches.
  • Eye-Hand Coordination: Handwriting, sports, and computer usage can all be affected when a child cannot accurately match what they see and what they do.
  • Visual Perception: Cognitive skills like memory, discrimination of shapes and letters, and spatial analysis are intricately linked to the ability to understand what we see.

What can a parent do?

First, we recommend a comprehensive eye exam, preferably by an optometrist who specializes in pediatrics or developmental optometry. Additional testing may be necessary to fine-tune a diagnosis and treatment plan. If a child’s vision issues are identified early in childhood, treatment can begin before a simple problem becomes more complex and a child “gives up” academically.

Additionally, there are steps than can be taken to reduce the eyestrain.

  • Ensure that desks and chairs are the right size for your children
  • Follow the 20/20/20 Rule
  • Use caution with screen time (see video below)
  • Use glasses as prescribed for everyday use or specifically for schoolwork
  • To limit the risk of children becoming nearsighted ensure children get plenty of outside time

Vision Therapy and Homeschool Families

Sometimes vision problems require Vision Therapy at Bright Eyes Family Vision Care and Bright Eyes Kids involves a combination of in-office therapy (usually once a week) and home-based therapy several days a week. Homeschool parents work with their children every day, and find it relatively simple to add home therapy activities to their daily routine. A one-time materials fee includes all the supplies needed for home therapy, as well as instructions for the assigned activities.

Visual Symptom Checklist

These symptoms may indicate a potential vision problem:girl schoolbooks 2

Physical Behaviors:

  • One eye turns in or out
  • Squinting, rubbing eyes, blinking
  • Head tilting, closing one eye
  • Finger guiding during reading

Complaints:

  • Headaches, especially after reading
  • Burning or itchy eyes
  • Double vision, blurry vision
  • Words move on the page
  • Does not like reading
  • Frustration with near work
  • Tired when reading

Performance Clues:

  • Frequent loss of place
  • Skipping words or lines
  • Omits or inserts letters or words
  • Poor reading comprehension
  • Difficulty copying chalkboard
  • Avoidance of near work
  • Inconsistent performance
  • Smart in everything but school

If you notice many of these symptoms, contact our office to learn more about vision problems effectively treated.

 

John John’s Vision Videos

Over the last few years John John has become a wonderful friend of Bright Eyes. He is an incredibly fun and inquisitive young man who loves to make YouTube videos. Everyone was impressed by his cute and surprisingly accurate early video about Eyes. After that, we started emailing and he eventually joined us for videos on How to Go to the Eye Doctor (over 22K views!), How to Get Vision Therapy (with me) , and How to Get Sports Vision Training (with Dr. Beth). He has also done videos on How Glasses are Made and How to Use Google Cardboard.

I’ve put the videos here in chronological order so you can see how John John has grown and the videos have improved over time.

And John John doesn’t just do videos about vision. Here are some favorites:

You can see all of John John’s videos and find out how to get in touch with him at his website http://amazingjohnjohn.blogspot.com/

-Dr. Nate

3 TEDx Talks on Vision and Vision Therapy

Ideas Worth Spreading about Vision Therapy

TEDx-logoChances are that you have heard of TED Talks. They are short live presentations designed to inspire awe, wonder, and curiosity. Or, as TED says, “ideas worth spreading.” Initially on the subjects of Technology, Education, and Design (T.E.D.), now talked cover almost every conceivable topic. I highly encourage you to find some mind-blowing Ted Talks to watch.

If you live in a moderately large large city, you probably have TEDx Talks.This is the local, independent version of TED, where everyday people can share what they are passionate about. Several years ago I presented a TEDx talk on the subject of hyperlocal social media and it was a lot of fun.

As the years pass, TEDx talks get better and better. I am happy to present 3 TEDx talks below about the important of vision and vision development.

From TEDx Victoria: Overlooking Our Vision

Sight is something many of us take for granted, but as Cameron McCrodan shows, there are many aspects of sight that are simply overlooked – and they can have a massive impact on our quality of life.

From TEDx Lincoln: Curing learning-related vision problems

Optometrist, Dr. Vicky Vandervort explains what it is like for a person to have eyes that work but do so inefficiently causing the person to exert extreme effort to see. When this occurs, people, especially children, do not realize the drain on their brain.

From Tedx Pioneer Valley: Fixing My Gaze

Susan R. Barry, Professor at Mount Holyoke College, talks about solving her severe visual problems through vision therapy. “As I began to straighten my eyes and see in 3D, I learned that the adult brain is indeed capable of significant plasticity. Rewiring in the adult brain requires the presence of novel and behaviorally relevant stimuli, the conscious abandonment of entrenched habits, and the establishment, through intense practice, of new ones.”

Enjoy these talks. They are a nice introduction vision therapy and shows why Dr. Beth and I are so passionate about in our work at Bright Eyes Family Vision Care and Bright Eyes Kids.

-Dr. Nate

Floaters – What Are They? [video]

People constantly ask me about floaters. This is good because they are paying attention and they know that they have been told that if they have a sudden change in floaters, either size or amount, they should call or come to the office right away to evaluate for potentially vision threatening problems.

But for most people, it turns out that we have floaters normally, we just don’t notice them that often. Right now, if I look at the computer screen and space out, I can see them, but I haven’t thought about them all day.

This is a nice little video that my mom sent me that explains floaters in an easy to understand way. I thought it would be good for sharing.

-Dr. Nate

Bright Eyes Family Vision Care and Bright Eyes Kids

InfantSee Vision Screenings for Infants 6 to 12 Months of Age

Most people are surprised to hear that the American Optometric Association recommends eye exams to begin at six months of age. By six months, your child has met several important developmental milestones. At birth, the eyes begin to focus about a foot away from the child, mostly looking at faces. Around two months old, the child is learning to look around. At this point, the eyes don’t always coordinate well together. Your child should be able to track moving objects by four months old and begin reaching for things. As their eye hand coordination improves, they will become more accurate in reaching for things.

InfantSee is a no-cost public health program that provides vision and eye health evaluations for children from ages six to twelve months. At your child’s InfantSee screening, Dr. Nate and I will be evaluating how well your child can see using specialized tests for infants. We look for excessive or unequal amounts of farsightedness, nearsightedness or astigmatism. If your child does need glasses to help them see better, we have a variety of frame lines at Bright Eyes that are designed specifically for infants and toddlers: Tomato, Miraflex and Bright Eyes Kids frames. Dr. Nate and I will also check your child’s eye alignment and eye teaming skills. During these kinds of tests, the children usually think we are just playing games with them, but in fact we are gathering lots of useful information about their eyes and vision. Additionally, we may dilate your child’s eyes to check for eye health problems. This is a normal procedure that we do for all ages, and we will only dilate your child’s eyes with your (the parent’s) consent.

It is important to look for risk factors that can cause vision problems in the future. If caught early, many vision problems can be corrected or prevented. Even if your child does not appear to have an eye or vision problem, you should bring them in for their first evaluation.

You may remember Dr. Nate’s blog about his daughter’s InfantSee examination. Check it out for cute pictures.

Call our office at 813.792.0637 or click on the button below to schedule an InfantSee appointment at either the Westchase or New Tampa location. Or visit InfantSee.org for more information.

-Dr. Beth

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Minecraft & Your Child’s Eyes

minecraftMinecraft doesn’t come up in conversation every day at Bright Eyes Kids, but pretty close to it. I typically ask all my patients, young and old, what they do for fun and Minecraft is the first thing many kids say. And if you spend any time at a mall, school, or other place with kids, you will see lots of kids in Minecraft-themed t-shirts (but you might not get the jokes unless you have played it yourself.) And now Microsoft just bought the company that makes Minecraft for $2.5 Billion (with a B). Clearly they think someone is playing this game.

I don’t have a “love/hate” relationship with Minecraft. It is more of “respect/worry” relationship.

There are many reasons why I respect Minecraft. I have read the story of how Minecraft came to be, and I must say, it is pretty cool: one guy making a game that became a community, mostly by himself. Being a huge Lego fan, I like the simplicity of building with digital blocks. I love all of the amazingly creative projects that dedicated players build.
But I do worry about all the Minecrafters. We have long known that Computer Vision Syndrome can affect office workers who spend their day on the computer. But children who spend a lot of time at the computer can develop the same symptoms. Simple Google searches show that Minecraft fans complain of blurry vision, headache, eye strain and red eyes, and they worry that the game is harming their eyesight.

Check out the infographic at the bottom of the post. It shows that kids are using devices for both fun and schoolwork. Parents tend to underestimate how much time their children use devices. Some kids use devices a lot – 7 hours or more each. I am betting that they do not find their off-screen homework as compelling as games like Minecraft.

Take this scenario: Parents bring in a child for an eye examination because their child is having headaches and blurry vision that only started in the last few months. When I ask if anything changed in this time, they will mention that their child got an iPad and have been playing Minecraft and other games. The evaluation confirms that the child is now having eyestrain and focusing problems from excessive device use.

This is more common than you might expect. In a recent AOA survey 4 out of 5 (or 83%) of kids say they have tired or blurry eyes after device use. That is a huge number!

Here are some suggestions to keep children’s eyes comfortable while using a device:

  • Check in with them, so you know how they are doing. Kids often don’t realize they are having problems.
  • Have them take frequent breaks (follow the 20-20-20 rule)
  • Limit their overall scree time and make them get outside.
  • Make sure they hold the device at a safe distance (Elbow distance)
  • Keep even room lighting
  • Wear reading glasses, if prescribed
If you have concerns about your children’s eyes or have concerns about the effect that device use may be having on their eyes and vision, call us to book an appointment. We would be happy to see your children at either Bright Eyes Family Vision Care in Westchase or the office just for children, Bright Eyes Kids in New Tampa.

DrNateSig

 

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screen_time_infographic

“Foolproof” Eye Test for ADHD

We have known for years that there is a link between how the eyes work and attention. This is why there are so many children who have both Attention Deficit Hyperactivity Disorder (ADHD) and visual coordination problems. Pediatric optometrists see this in the exam room every day and it is our job to help sort out how much of a child’s difficulty is due to ADHD and how much is due to not being able to visual focus and move their eyes efficiently.

There is some new research about ADHD and eye movements that is very compelling. Researchers in Tel Aviv, Israel, led by Moshe Fried, MD, have found that by simply monitoring involuntary eye movements, ADHD can be diagnosed.

“This test is affordable and accessible, rendering it a practical and foolproof tool for medical professionals,” said Dr. Fried. “With other tests, you can slip up, make ‘mistakes’ — intentionally or not. But our test cannot be fooled. Eye movements tracked in this test are involuntary, so they constitute a sound physiological marker of ADHD.

The study also showed that Ritalin (methylphenidate) does work in improving ADHD as measured by eye movement control. What was not researched in this study is how much other treatments that also improve eye movement control influence ADHD. Optometric vision therapy is commonly used to help patients improve their voluntary and involuntary eye movements.

Clearly more research is needed to better understand the relationship between ADHD and eye control, but this new study is a step in the right direction.

DrNateSigMagnetCapture

 

Visual Skills Needed for School: What to Look For

1172548_10150392203379977_1539208274_oI know it is the height of summer. But the “back to school” season is right around the corner. New schools, new teachers, and new challenges await every student. Good vision is among the many skills children need to read, write and learn their best. Many parents do not realize that vision is more than being able to see the words on a page or board clearly, but it is actually a form of fine-motor skill. Just like it takes years to master the fine motor skill of controlling the tiny muscle of the fingers to write legibly, it takes years to master the coordination of the even smaller muscles that move and focus the eyes. Continue reading

Bright Eyes Kids is Open!

 

This is no April Fool’s joke! Bright Eyes Kids is open!

 

This is the moment that we have been waiting for…We are ready to see general children’s appointments at Bright Eyes Kids, as well as Vision Therapy, and Orthokeratology patients! 🙂

Bright Eyes Kids is the only optometry office around dedicated specifically to children’s vision. We do care the same great infants and children’s glasses that you can find at Bright Eyes Family Vision Care. The new office is located at 15303 Amberly Drive Suite C, Tampa, FL, 33647. It is office Bruce B. Downs, near the Bank of America and LA Fitness. The hours currently are Monday and Tuesday 9am to 5pm.

If you have a special child in your life that needs their eyes and vision checked, call us at 813-792-0637 (yes, the same number as Bright Eyes Family Vision Care) for more information or make an appointment. Bright Eyes Kids also has its own Facebook page.

Dr. Nate

By Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
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