FOCUSING ON KIDS' VISION.

Byline: Marilee Reyes Staff Writer

School is once again in full swing and students are being asked to focus on learning - a difficult task if the lessons are blurry.

Life is tough enough when you're trying to grow up and absorb everything in school without having to squint to see the blackboard in class or struggle to read a textbook or work at a computer.

And youngsters can have vision problems and not realize it.

``The problem with vision is we see only as well as we think we see,'' says Kathy Schreick, an optometrist at Family Eye Center in Van Nuys. ``Children aren't sophisticated enough to say, 'I don't think I'm seeing as well as the person next to me.' They don't have a reference point.''

Therefore, it's important that parents or a responsible adult be observant and aware of signs a child might have vision problems, such as holding a book too close, rubbing eyes or lagging behind in school.

``Due to vision changes that occur during rapid growth phases, kids should have their eyes examined annually by an eye-care professional so that potentially serious disorders are detected,'' warns Dr. Rod Tahran, professor at Southern California College of Optometry.

According to Tahran, parents should not rely strictly on vision screenings administered at school because those screenings usually only test for visual acuity, or the ability to see things at a distance.

Additionally, visual skills that should be evaluated with an eye exam are: tracking (moving the eyes smoothly and accurately along a line of print), focusing and eye teaming, or using both eyes.

Dr. Walter Fierson, a pediatric ophthalmologist and clinical assistant professor in the Department of Ophthalmology, USC School of Medicine, agrees an annual exam is best, but adds that the frequency of examinations depends on individual circumstances.

``A child should have a vision exam at least by the age of 2 or 3 years. There at least needs to be an examination by a pediatrician (which is a normal part of a physical) to check for any difference in the eyes, such as tracking or for lazy eye problems,'' says Fierson. He adds that before children begin kindergarten, they should have a numerical rating vision examination, that is an evaluation of the degree of visual accuracy (i.e., 20/20 vision).

``One of the most basic things we (vision professionals) depend on is the family history. Frequently, eye problems turn out to be familial.''

In other words, if there is a history of nearsightedness (myopia) in the family, the chance of a child having the same vision problem is greater than a child whose family has no history of problems. Although, adds Fierson, that is not always the case, only that there is a greater probability.

Other disabilities that are often familial and incorrectly thought of as being related to vision, are dyslexia, a variety of language defects and attention deficit disorder.

When parents take a young child to an ophthalmologist for an eye exam, the parents should expect a different approach than that used for adults.

``In a pediatric ophthalmological setting, visual acuity is measured in a somewhat more sophisticated way,'' he explains. ``The whole (office) structure is designed around getting the child's cooperation,'' adding that although the approach seems casual it is still efficient.

Magnification equipment checks the physical structure of the eye, and toys are used to observe vision tracking. This combination of techniques allows the doctor to make a structural and functional evaluation of the eye and vision.

Fierson, who has offices in Pasadena and Arcadia, also teaches public school personnel how to conduct state-mandated vision screening. ``These are not really vision exams, though,'' he says, ``but oftentimes they do uncover a problem, and according to state requirements, parents will be notified if any problems are discovered.

Myopia (nearsightedness, or the inability to see things in the distance) is the most common vision problem, and often starts early in life, around the second or third grade.

While the degree of personal responsibility varies with each child, Fierson says glasses are usually prescribed, rather than contact lenses, if the need is discovered before the teen years. ``In general, I like to say they should be old enough to be responsible to take care of lenses. On average, it usually works out to be about 11-12 for girls, 13-14 for boys.''

Refractive (laser correction) is not a good idea when children are immature because the eyes will continue to change, and future surgeries would have to be done, possibly on a yearly basis. Not only would this be impractical and expensive, but any unnecessary surgery should be avoided.

Staff Writer Evan Henerson contributed to this story.

In the line of sight

Signals that indicate vision problems:

--Rubbing eyes repeatedly.

--Holding head at an angle when looking at an object.

--Shutting or covering an eye to focus.

--Using finger as a placemark while reading.

--Holding books closely.

--Complaining of headaches after reading.

--Sitting too close to the TV or computer.

--Developing red or crusty eyes.

To help avoid eye problems:

--Be sure homework area is evenly illuminated and free from glare.

--Make sure the child takes frequent breaks to rest the eyes while studying, reading, using the computer or playing video games.

--Visit an eye-care professional for an annual exam.

--Be sure the exam includes a review of vision history.

--Tests should be included for nearsightedness, farsightedness, astigmatism, lazy eye, color perception, crossed eyes, depth perception, eye coordination and focusing ability.

--When using computers, the child should sit at a reasonable distance from the computer. Sometimes older monitors get jiggly, which can cause tired eyes, but in most cases shouldn't harm the vision.

CAPTION(S):

3 photos, box

Photo:

(1 -- cover -- color) The eyes of a child

Professionals recommend beginning vision care early.

(2) Josh Ortiz, 12, of Mission Hills has his eye examined at the Family Eye Center in Van Nuys. Vision-care professionals recommend annual eye exams for youngsters.

(3) ``The problem with vision is we see only as well as we think we see,'' says optometrist Kathy Schreick.

Charlotte Schmid-Maybach/Staff Photographer

Box: In the Line of Sight (see text)