Kids, Sports & Spectacles…- For the responsible parent
Of late sports have started receiving more attention in our kid’s lives. Most schools stress on an all-round development and encourage children to take part in sports. It is obvious that sports help children get exercise and develop physical skills. But more than that, sports are about learning teamwork and fair play. And all this is done while making friends and having fun! The lessons they learn while playing, shape their values and behaviours for future life.
But a small hiccup arises for some when their child is detected to have weaker eyesight and needs to use spectacles for correction. Many parents/teachers wrongly think it is safer to discontinue outdoor sports for children with spectacles, mainly, due to higher risk of injury and lower performance due to poor eyesight and spectacle usage.
We, as parents and teachers, needs to understand why it’s important to promote outdoor sports even if our kids wear spectacles and what added precautions are required in these children.
Refractive errors and spectacles:
Kids need to wear glasses to see clearly because of Refractive errors. Commonly, the refractive error in children is Myopia. It is the commonest eye problem and is estimated to affect 1 in 5 persons. Normally, we are able to see an object clearly when the light coming from the object is focussed correctly onto the retina. In myopia, the eyeball of a child grows longer than usual. This causes the light entering the eye from distant objects to focus in front of, instead of on, the retina (image 1).
As a result, the distant objects appear blurry. Light from near objects still gets focussed correctly and they appear clear. Hence myopia is also known as short-sightedness or near-sightedness.
The treatment for myopia is commonly with corrective “minus power” spectacles or contact lenses, which refocus light onto the retina.
Lifestyle changes:
Interestingly, the number of myopes has been on the rise for the past few decades. One of the reasons for this is the changing lifestyle.These days, more and more children spend their time watching television, working on computers and playing on mobile phones. Greater time spent indoors, doing work that involves focusing on close objects is known to increase the risk of myopia, especially in those with a family history of this condition.
Additionally in kids with uncorrected myopia who cannot see distant objects clearly, they furthermore prefer to stay indoors and play with objects close to them. This in fact might even aggravate their condition. It is no surprise that children from urban environments are more than twice as likely to be myopic as those from rural environments.
This shows how important it is to encourage children to spend more time playing outdoors. Not only is it good for the overall physical and mental development of the child but it may help the vision as well.
How do we correct refractive errors?
In children we have limited options for refractive error correction. Contact lens usage is usually discouraged until they learn to use them correctly. However, if they still wish to use them, proper care should be taken to prevent complications & infections, Surgical options in the form of refractive surgeries are available only after the age of 19.
Refractive surgery can help refocus the light correctly onto the retina by permanently changing the shape of the cornea and is a great option to consider. Spectacles are the easiest and safest method of correction of myopia in children.Children require more frequent follow-ups than adults for correct spectacle prescriptions and it is preferred to consult a paediatric ophthalmologist to also assess other eye problems.
What we should look out for?
Spectacles, although recommended, provide a restricted field of view and playing sports with spectacles might become inconvenient and even dangerous at times. Some kids are also more prone to injuries to the face, head or the eyes due to their restricted view. It is recommended to choose the right kind of spectacles for your kids whenever possible. Contact lenses are advantageous in these cases as they provide a wider field of view, but are best avoided in smaller kids. Contact lenses are traditionally difficult to manage and can also cause complications like dry eyes and infections if not handled properly.
Any injury to the eyes or to the head can send shock waves to the jelly inside the eye (called as vitreous). This can result in a pull on the retina increasing the risk of damage. This risk is even more in kids with high refractive errors who wear thicker lenses.An eye is considered to have high myopia if it needs -6.0 diopters or more of lens correction. Nearly 40% of such high myopes are at risk of developing retina-related disorders.
The Retina:
This is due to the extreme elongation of the eyeball, resulting in the stretching of retina. This can lead to retinal degenerations, breaks and detachment.
The central part of the retina (called the macula) can also develop atrophic changes, abnormal vessel growth under it, macular hole or separation of its layers (called as schisis). All these can cause significant vision loss.
Often these myopes have no symptoms and are not aware of their retinal condition until it is too late. Regular retinal check-ups are essential to ensure that the retina is not at risk.
Retinal degenerations and breaks if identified in time can be treated with green laser and further complications like retinal detachment can be prevented. The retinal laser is a simple 5-10 min procedure done on an OPD basis and needs no additional precautions pre or post treatment.
Are all sports that risky?
No, not all sports carry equal risks. All contact sports (boxing, martial arts, kabaddi, etc.) need the most attention as they carry the highest risk for injury and trauma. Sports involving fast moving heavy objects (cricket, football, etc.) carry additional risks of injuries. A cautious approach is advisable when kids take up these sports. Once children are comfortable with their spectacles, they will be more confident and enjoy these sports. Indoor sports like badminton, table tennis etc are some of the best to choose from.Sports like athletics are also a safe option.
There are protective glasses now available made of materials that are safer and if the child loves such a sport, he/she should still be able to play safely.
In Conclusion:
Besides the obvious health benefits, it cannot be denied that one of the reasons for this sudden amplified interest in sports is the increasing competition and easy access to various sports facilities. Innumerable coaching classes have cropped up and every parent wants their child to be the best.
Therefore, efforts must also be made to understand good vision and its importance towards sports and the child’s health. The earlier generations also played sports but rarely received any formal training and a lot of sports related injuries were conveniently overlooked.
While involvement and participation in sports must be encouraged, parents must ensure that their child develops good sportsmanship and that enjoyment takes priority over winning. At the same time, their eyes should also be looked after regularly and kids with spectacles should, in no way, be denied their right to enjoy the sport of their choice.
After all, kids should enjoy every bit of their childhood and sports plays an important role in not only engaging children but also building their character.
Vitreo-Retinal Surgeon
Bhaskar Eyecare, Thane