February 2024

Dis lente en die bottende bome en helder blommekleure tel sommer ‘n mens se gemoed op. Vir heelwat kinders en hulle ouers is dit egter ook die tyd van die jaar wat hulle met ‘n swaar gemoed sit omdat dit ook die tyd is wat hulle in kennis gestel word van skoolwerk wat nie op standaard is nie. Hulle loop dus met ‘n swaard oor hulle koppe dat hulle dalk die graad sal moet herhaal of selfs na ‘n remediërende klas of -skool oorgeplaas gaan word. Baie keer gaan dit ook gepaard met ‘n etiketering van die kind – so asof die kind se selfbeeld nie al genoeg afgetakel is deur haar/sy gesukkel nie.

Life is a blur for iPad kids article in times. Download and view here: mindmoves artikel KIND EN NABYPUNT SPANNING

CHILDREN as young as three are developing eye problems and struggling to read because they spend too much time playing on iPads.

This is according to Professor Jannie Ferreira, former head of the University of Johannesburg’s optometry department.

Speaking at the Cotlands Southern Africa play conference yesterday, he said a three-year-old patient he had treated recently squinted so badly that the child’s eye looked directly at his nose. He had been spending three hours a day on an iPad, watching videos and playing games.

Myopia, or short-sightedness, was increasing worldwide due to the time children spent in front of computers, phones or tablets, Ferreira said.

“Short-sightedness is at epidemic proportions, according to the World Health Organisation,” he said.

Life is a blur for iPad kids article in times. Download and view here: Life is a blur for iPad kids article in times

There are a number of accommodative functions and it is often difficult to decide which of these functions are most applicable when testing accommodation in children.

The amplitude of accommodation is perhaps one of the most frequently measured visual functions to clinically determine the accommodative function of patients presenting with symptoms of binocular dysfunctions. Other tests of accommodative functions include lead/lag of accommodation, accommodative facility and a cycloplegic refraction (Wick & Hall, 1987).  The lag/lead of accommodation represents the discrepancy between the accommodative stimulus and the response (Cooper, 1987; Saladin, 2006; Barret & Elliot, 2007). The lag of accommodation is believed to be due to the effect of the depth of focus of the eye (Flom, 1955; Rouse, et al., 1984; Cooper, 1987). Accommodative facility is the ability to alter accommodation with a change in the fixation distance (Wick & Hall, 1987) or lens induced blur (flipper lens test) (Saladin, 2006). These tests are necessary in order to diagnose accommodative anomalies such as accommodative insufficiency, accommodative excess as well as accommodative infacility (Scheiman & Wick, 2008).

Testing Accommodation in Children. Download and view here: Testing Accommodation in Children

The role of vision in sports performance is a topic that has always attracted considerable attention and has been studied quite extensively over the years. Quite recently statements and announcements made by a number of high profile professional sporting organizations and individuals on the contribution of sports vision to their success resulted in a global increased public awareness. Most studies on sports vision still originates in the disciplines of sport science and sport psychology. In optometry it seems that behavioural optometry has claimed it as part of their domain and that is certainly scaring away the more traditional optometrist. The reality is that Optometry is the only professional that can provide the whole range of sports vision services. According to Reichow and Stern, sports vision encompasses performance orientated comprehensive vision care programmes involving the education, evaluation, correction, protection and enhancement of the athlete. Furthermore, the notion that sports vision is only for the elite athlete is definitely not true. The biggest market is in children and the casual athlete.

At the University of Johannesburg we have created an Academy of Sports Vision and our whole philosophy is based on what we call the four cornerstones of sports vision being:

Provision of Corrective Eyeware

Visual skills testing

Performance Enhancement

As there a place for sports vision in private practice. Download and view here: Is there a place for sports vision in private practice

Been made aware of developments in China with regards to the use of electronic devices by children under the age of eighteen years prompted me to write this article. In August 2021 the Chinese Communist Party passed a new law forbidding children from playing video games for more than three hours per week [1].

Impact of electronic devices on vision in children. Download and view here: Impact of electronic devices on vision in children maart 2023

Demographers and researchers have been using the term ‘Generation’ at various times throughout history to describe alienated youth as belonging to a specific cohort born over a specific period [1]. This became common practice after World War II and we saw the Baby Boomers followed by Generation X [born between 1965 and 1979] and Generation Y [born between 1980 and 1995]. It is believed that each generation has common characteristics that give it a specific character. This approach is very popular in the world of business where companies are using it to try and predict preferences and spending patterns. The characteristics are mostly determined by socio-economic and political influences, but since the 1990’s the impact of technology has become the overriding factor. This coincided with the introduction of a new generation, called generation Z. They are also known as “digital natives” because they are extremely comfortable with technology and have experienced more advancements in technology than all previous generations put together. From an optometric perspective it is important to understand how this may impact on visual requirements and on vision in general.

Generation Z and Generation Alpha. Download and view here: Generation Z and Generation Alpha – Test 233

Introduction:

Since Sue Palmer published her book called Toxic Childhood in 2006 [1] numerous publications appeared on the dangers associated with excessive use and exposure to hand held devices. Apart from all the social and psychological challenges today’s children are also facing significant physical deprivations. In the vision care domain we are seeing a significant increase in conditions such as near work induced transient myopia (NITM) and also acute acquired comitant esotropia (AACE). In 2016 Lee et al. [2] reported on this unusual presentation of esotropia in children using smartphones for more than four hours per day. In my own practice I have seen 10 children between the ages of two and six years over the last six months presenting with AACE related to the excessive use of hand held devices.

Children and Technology AACE. Download and view here: Children and Technology AACE article

I have the following hypothesis that I wish to share with you: If you are –

• A boy
• Born between September and December [children in South Africa]
• Have cross dominance or left eye dominant

Then you have a 100% chance of being labelled ADHD, ADD or dyslexic.

The whole ADHD debate is something that has been on my mind for some time. I simply cannot accept that so many children are deemed to suffer from this genetic disease. Yes the supporters of this concept call it just that. How is it possible that we as humans seem to be unable to adapt to our environment and why is there such an increase in children with ADHD since the turn of the century. The CDC [Centre for Disease Control] in the USA recently estimated the treatment cost together with the societal and personal costs to be in the order of 31.6 billion US dollars per annum [in the USA]. This would then include:

• Health care for persons with ADHD
• Health care for family members specifically related to the family member’s diagnosis
• Work absence among people with ADHD and family members.

Braking the shackles of ADHD labels. Download and view here: Braking the shackles of ADHD labels mindmoves article

Introduction

Seeing older myopic patients [older than 50 years] for the first time I often find the glasses that they are wearing to be over-minus by as much as -1.50 dioptres. This prompted me to find an explanation for this trend. Is it a case of a poor refraction or are we seeing a reduction in myopia since their previous visual examination? Furthermore, I have experienced a +1,25 shift in my own refractive error during my presbyopic years and hence this article.

Studying the literature, I found several studies reporting a decline in the prevalence of myopia in older adults. As far back as the 1980s and 1990s several studies in the USA reported on this phenomenon and it is therefore surprising to find a significant number of optometrists acknowledging to me that they are unaware of this. The obvious question is: why is this happening? Trying to find an answer to this showed that several studies reporting on age related changes in myopia during the presbyopic years produced contradictory results. It is important to identify and understand the potential factors underlying these changes, particularly if they relate to pathological causes, to allow us to understand the future health care needs of our aging population.

Article Myopia in Presbyopia. Download and view here: Article Myopia in Presbyopia