Being aware of potential eye problems and offering eye protection to their children are the most important steps parents can take to ensure their children's eyes remain healthy. Eye problems can be identified through vision screenings and by observing the red reflex, while protection can include wearing safety goggles or sunglasses.
These essential measures are recommended by Lt. Cmdr. Kyle Miller, the pediatric ophthalmologist at Naval Medical Center Portsmouth, during Children's Eye Health and Safety Month.
Miller, the only active-duty pediatric ophthalmologist in the Navy, sees about 45 to 50 patients per week in the clinic, while also operating on babies, children and adults for several eye conditions. He said there are three typical conditions that trigger a patient referral.
"The first is a young child with crossing eyes, and that is the most common surgery I perform, which is strabismus surgery, or realigning the eyes," Miller said. "I also treat adults with strabismus. A patient comes in with what some call a lazy eye, or an eye that drifts or eyes that cross. I perform surgery on the muscles to realign them. It's a very common procedure for pediatric ophthalmologists."
Miller commonly sees patients who have failed a vision screening at their school or pediatrician's office and are referred to him because they are not seeing as well as they should. This includes children whose vision screening indicates they are color blind.
"The next most common patient I see is young babies under a year of age with a blocked tear duct," Miller said. "They have a lot of drainage or tearing from the eye, so the second most common surgery I perform is the nasal duct obstruction surgery. I also do rounds in the Neonatal Intensive Care Unit looking for retinopathy of prematurity, which is a condition that can lead to blindness."
Miller recommends that parents simply observe their children's eyes regularly, and that through awareness, they can help identify these conditions.
"If their eyes are crossing beyond age three months, they should be seen by seen by their pediatrician. Parents should also look at the red reflex in photographs. When you take a photograph of someone with flash and you get the red eyes, the red should be the same in both eyes. If there's a difference, like one eye has a white reflex, that could be a sign of a tumor in the eye or a cataract, and is a reason to be evaluated by a pediatrician."
Beyond conditions of the eye, Miller is also concerned with helping prevent eye injuries.
"People don't always think about sporting activities for children that the professional organizations recommend eye protection for," Miller said. "Eye protection should be worn for shooting sports like paintball, and even sports like basketball to protect eyes from finger pokes. For any high-speed ball sport, like baseball and lacrosse, we recommend eye protection even if they don't need glasses to see clearly."
Eye protection should also be worn while using anything that can propel an object with high velocity, such as a lawn mower, a hammer or wrench, or power tools. Keep other foreign objects out of the eyes, such as cosmetic contact lenses for use at Halloween, because they can cause irritation and injury.
It's also important to protect children's eyes from damage that the sun's UV rays can cause.
"Kids need sunglasses when they are outside, because extended UV exposure does affect the eyes," Miler said. "If you are going to the beach, or spending a lot of time outside, children should wear UV protection for their eyes along with their sunscreen."
Miller also recommends that every child should have their vision screened at least by their pediatrician or primary care physician in the preschool ages and as they reach three, four and five.
"Every state has vision-screening requirements. The vision screening is performed through the pediatrician and then through school, and if something is identified, then they should be referred to an optometrist or ophthalmologist," Miller said. "For children who need glasses, an eye exam once a year is appropriate. As children grow and the eye changes shape, their vision is going to change. It's going to change about once a year, maybe every 18 months or two years. Vision changes the most by the time a patient reaches their early 20s, so annual screenings should be continued until then."
Miller said for those who have been identified as near-sighted, playing outside regularly and making sure they are reading at an appropriate distance can help reduce the progression of near-sightedness.

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