Behavior may not imply vision problem

From Tots to Teens

August 27, 1996|By Dr. Modena Wilson and Dr. Alain Joffe | Dr. Modena Wilson and Dr. Alain Joffe,SPECIAL TO THE SUN

When my 5-year-old wants me to look at something, she pokes it right under my nose. She puts it so close I can't focus on it. Why does she do that? Is there something wrong with her vision?

It sounds as though you are wondering if your daughter is nearsighted, because she acts as though you are. People who are nearsighted need to get close to objects to focus on them clearly. Nearsightedness or myopia results when light rays coming from an object pass through the focusing parts in the front of the eye (cornea and lens) and converge before they get to the retina. This might happen because the eyeball itself is a bit too deep or because the cornea and lens are bending the light too much.

The retina is the sensory layer at the back of the eyeball that sends messages to the brain. The brain then processes those messages and creates the images you see. If the light rays converge in front of the retina, the image the brain creates of distant objects will be fuzzy. People who are myopic try to clear up fuzziness by moving objects closer to their eyes and sometimes by squinting. The more myopic, the closer they must hold something to see it clearly.

Most children are born somewhat farsighted, but by about 3 years have what we consider normal vision. They are neither nearsighted nor farsighted. When they start to read, they are comfortable with a book at the same distance from their eyes as an adult who does not need glasses.

Now back to your daughter. If she is nearsighted, you should be getting other clues. She might be sitting closer to the television than the rest of the family, squinting when she looks across the room or bending very close to the book when she colors. When you are reading a book together, she might want to hold the book closer than is comfortable for you. If nothing like this is happening, we suspect her presentation of objects to you says more about her sense of urgency than her vision. She is showing you how much she wants your undivided attention.

Dr. Wilson is director of general pediatrics at the Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.

Pub Date: 8/27/96

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