I was 12 years old, squinting to read while in school, and not realizing I couldn’t see well because of a vision issue. My aunt, picking me up from school that day, peered into the classroom window and noticed me squinting and holding papers close to my face. She then insisted on a trip to the eye doctor. Apprehensive and unsure about needing to wear glasses, this visit to the eye doctor worried me.

That same trip was the spark that brought me to where I am today and motivated me to pursue a career as an eye doctor. Although I was young, the doctor treated me as an equal and involved me in my own care, providing clear explanations for all of the tests, examinations, results and why I would need glasses. I remember feeling that I wanted to also help others in that same way. When I embarked on my optometry education, I recalled my earlier experience and made it a priority of mine to provide people with the same feeling of being involved in their care, understanding why and where their vision issues came from. That doctor that saw me as a young 12 year old may not know it – but his character, patience and empowerment helped shape me into the individual I am today. Being an eye doctor has become a part of my identity. It embodies many things I stand for: to care for others, to empathize and to empower patients to embrace their eye and overall health.

Of course, however, there were struggles during my journey. Throughout my academic career and beyond, there were individuals who questioned my ability to be accepted into an optometry program, to succeed once I was in, and to succeed even after I had completed my education. I have learnt to deal with this challenge over time, recognizing that there are always circumstances in which others may not support you, but at the end of the day, the most important person to support you, is you. I am proud to say that I persevered irrespective of these opinions, as I am now pursuing my passion.

This brings me to a key point: parental and caregiver guidance for developing children is extremely crucial. Children look to parents and elders as role models and model their behaviours accordingly.  Engaging children in conversations about what they enjoy, and talking with them can help to make them feel involved and discover their passions. Encouraging and facilitating their interests allows them to explore and grow.

When we think about the health of our children’s eyes, there are many considerations that I will outline.

Disconnecting from electronic devices to give our eyes a break and help replenish our tear film.  When we are on electronic devices, we blink half as often as normal. The mechanical action of the blink helps to secrete a specific fluid in our meibomian glands, thus in turn stabilizing our tear film. When we do not blink enough, the glands can become clogged and cause dry eye disease symptoms. Now, how do I tell my son he cannot be on his electronic devices for more than 30 minutes a day when I myself work well into the evening hours on these very same electronic devices? “Mom stop working” has become a staple phrase in my household. While I hope that a positive aspect of this is that my children can recognize the value of hard work in achieving one’s aspirations, I worry that I am not be setting the best example for work-life balance. I wonder, how am I to educate them on the dangers of electronic devices, when I do not take my own advice. After all, children have never quite followed a “do as I say, not as I do” mantra. This is why it is imperative for parents to reflect on their own actions, as children model their behavior based on what they see their parents do. When we tell our children not to use their electronic devices, we must also disconnect and engage in other activities. This is something that I myself continue to work on.   

Alternating indoor activities with outdoor. I grew up in a household where if it was cold, we sheltered indoors. Now that I have kids of my own, I recognize the importance of embracing outdoor activity all year around. Our children’s eyeballs continue to grow until late adolescence and early adulthood.

The more ‘near work’ the eyes do, the more the muscles of the eyes change and flex in order to bring a clear image to the brain. In eyeballs that are still growing, excessive ‘near work’ can cause the length of the eyeball to grow faster than the average individual. Experts have indicated that the prevalence of myopia (nearsightedness) is increasing at an alarming rate, with certain regions seeing myopia at epidemic proportions. A paper published in the journal Ophthalmology estimated that by the year 2050, 50% of the world will be nearsighted, and 10% are at risk of high myopia (severe nearsightedness).[1] This is alarming, but preventable.

Practice moderation when using electronic devices. It is not easy to say no to our children when many of their peers are being told ‘yes’. When my son was six, he asked for a cellphone as some of his other classmates had cellphones. It is often tempting to provide our children with what all the other children appear to have. While technology is here to stay and children need to learn how to use electronic devices, balance and moderation are key. There must be a balance between their overall health, and the knowledge of technology that is required in our present society. As discussed, excessive ‘near work’ and device use can alter the structure of the eye glands, and therefore moderating the amount of exposure is essential. As parents and caregivers, it is our role to guide our young children. Without this guidance, children may easily spend hours at a time on an electronic device, without fully understanding the implications on their future eye health.

Investing in our children’s eye health is a key part of investing in their overall development. When we arm our children with the right tools and knowledge from a young age, we are instilling healthy habits that will help them thrive throughout life, helping to raise healthy and well-balanced individuals.

[1] Holden et al. (2016). Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Opthalmology, 123(5), P1036-1042. doi: 10.1016/j.ophtha.2016.01.006

As the war against the pandemic rages on, industries across the globe have had to pivot in response to the nation-wide lockdowns and restrictions, eye health included.

What is in store for the world of eye care service delivery? We created this series to hear from the eye health professionals themselves. This week, we caught up with optometrist, Dr Rashele Sharkey, O.D.

She shared with us her journey as an optometrist, learning moments, parenting tips and thoughts on the road ahead for the eye health field.

What are some important things parents should know about their children’s eye care? 

I can’t stress enough how important getting an eye exam* is for a child. According to experts, 80% of learning is visual. Imagine trying to do something new if the directions were blurry, and then be asked to demonstrate what you learned!

When certain skills have not developed, or are poorly developed, learning can be difficult and often stressful. Parents should look out for signs of vision problems that may include frequent blinking, headaches, poor reading comprehension or losing their place while reading, for example.

According to the American Optometric Association (AOA) children should have their eyes examined by an eye doctor at 6 months, 3 years, at the start of school, and then at least every 2 years following. It is important to note that even if a child passes a school screening, they could still have an underlying vision problem not tested for or detected. Vision can also change frequently during these years of development, so comprehensive eye exams with an optometrist are important. The earlier a vision problem is diagnosed and treated, the less it will impact the child’s learning and quality of life.

Outside of the pandemic we are currently witnessing, there is also a myopia (or “near-sightedness”) pandemic rising in the world, particularly in children. Children who spend a lot of time engaged in near activities (reading, using handheld electronics, etc) are appearing to face a bigger risk of developing myopia. 

However, It has been found that spending more time outdoors can lower the risk of childhood myopia. So, tell the kids, GO OUTSIDE AND PLAY!!

What is the biggest struggle you have faced as an optometrist and how did you overcome it? 

Being an underrepresented figure in my field, I have struggled with being accepted in a predominantly white, male driven profession. Currently, only 2.7% of practicing optometrists are African American which makes advocating for my profession even more important. The COVID-19 pandemic has truly highlighted the systemic bias minorities face when it comes to health disparities and access to care in general.

When it comes to making changes and fighting for expansion in our scope of practice, every voice matters. I advocate for preventative eye health of all races and I hope to bring more awareness to my field being a young, African American female practitioner. I can’t count how many times a patient is surprised when I walk in and tell me “You are the first black optometrist I’ve ever had!” It’s crazy to think there is still such a handful of minorities in this field. We are truly unicorns in our profession.

I strive to continue to mentor young students interested in optometry to broaden their perspective on the field and will be initiating a Podcast called “The 3%” with some of my colleagues that address these topics. Coming soon! 🙂

What are the 5 biggest things you’ve learnt as an eye professional?

  1. Optometry is a constantly evolving field. To be a good doctor you have to dedicate to being a lifelong learner. It is important to keep up with emerging research and new innovative technology.
  2. Not all corporations are equal. I have worked in corporate optometry since I began practicing 3 years ago. Although this route may not be for everyone, I admire my company’s core values and efforts to deliver affordable eye care throughout the country. It is important to choose a corporation that not only values you but also your patients as a whole. 
  3. No patient is alike, and it is important to remember that. While your purpose is to attend to their visual needs, you also catch a glimpse of their story, and make a meaningful connection. You begin to see not just the eye disease or abnormality, but who your patient is as a person. 
  4. Honesty is the best, best policy. Being in healthcare, you won’t always have the ‘easy’ patient all the time. I am often confronted with delivering not so great news that patients may not want to hear. But you must maintain that dialogue and be honest with them to deliver your plan of action. 
  5. Most importantly, I have learned about myself. I have grown in my abilities, made important decisions and connections with people that have shaped my life and who I am in ways unimaginable. I love my field and look forward to the new adventures that await!

Visiting an optometrist is just as important as visiting a dentist. We created Plano Eyecheck, an easy-to-use online platform to connect families in Singapore to their nearest optometrist. Locate, book and manage your appointments for a variety of eye care services, including comprehensive eye check-ups and myopia control consultations here.

*Plano Eyecheck is currently in Singapore with plans to expand internationally to close the loop for eye care service delivery worldwide.

Disclaimer: The views, thoughts and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of Plano. Any content provided by our guest bloggers or authors are of their opinion and are not intended to malign any religion, ethnic group, club, organization, company, individual or anyone or anything.

This vision care specialist describes what she does and why it’s important to take your toddler for an eye check!

Impressed with the optometry booth at a local polytechnic, Iryn Gan, (now 34), decided to pursue this career option.

“The course is very specialised and it covers detection of eye diseasesmanagement of eye complications, the prescription of eyewear and more,” Gan says.

After graduating with a diploma in optometry, Gan decided to get a degree in the subject at Cardiff University in the UK.

Today as a consultant with Johnson & Johnson Vision Care (Acuvue) Singapore, Gan provides training to optometrists, opticians and optometry students. She helps them improve their skills and updates them on the latest contact lens technology in the market.

In particular, Gan says it’s important to stop childhood eye problems from progressing. “Singapore has one of the highest rates of childhood myopia in the world, even though the Health Promotion Board recently reported that the rate has remained stable over the past decade,” she notes.

Hi Iryn, could you tell us more about your job scope and what a typical day is like for you?

As a consultant, I visit optometrists in optical shops to share my experiences and practice management techniques, so as to enhance their clinical skills. I am also a visiting optometrist at United Eyecare (@unitedeyecare), and through this, I am able to keep in touch with the optical retail industry to better understand the challenges faced by optometrists and opticians. I’m also a mum of two, so I’m constantly trying to juggle work and family life!

Young children who develop myopia early in life tend to have higher eye degrees and face a higher risk of eye problems later in life.

Indeed, since you’re a mum yourself, what are some of the most pressing eye issues/problems you see with kids today?

Young children who develop myopia early in life tend to have higher eye degrees and face a higher risk of eye problems later in life. It is very important to control the progression of childhood myopia as it can progress very quickly.

Strabismus (squint), amblyopia (lazy eye) and color vision deficiency are also quite common in children. Early detection is important because treatment tends to be more effective when the child is younger. Untreated strabismus and amblyopia may lead to permanent visual impairment.

Since you mentioned myopia, is there any way to stop it from progressing?

The ways to control myopia progression includes practising good eye care habits, wearing myopia control glasses or special contact lenses, and using atropine eye drops. Parents should talk to their eye care professional to decide which method best suits their needs.

How early should kids be going to get their eyes checked?

A child’s first eye exam should occur before entering kindergarten or by age 5. Myopia is genetic, which means that children with myopic parents have higher chance of being myopic. These kids should get their eyes checked at age 3 or 4.

If a parent notices any eye problems, they should have their child examined right away, so that the problem doesn’t become permanent. Any undetected and uncorrected vision problems in the child could result in developmental delays and learning difficulties.

What are signs of eye problems in children?

Signs that a child may have vision problems include constant eye rubbing, squinting, poor focusing, poor eye tracking (following an object), abnormal eye alignment or movement, and the inability to see objects clearly at a distance or near.

Any undetected and uncorrected vision problems in the child could result in developmental delays and learning difficulties.

What can parents expect when they bring their kids to get their eyes checked?

Parents should bring their kids to see optometrists who use child-friendly tools to make the visit pleasant and engaging. During the consultation, the optometrist will assess the kid’s vision, refractive errors (eye power), eye-focusing skills, eye alignment, colour vision and 3D vision. A referral might be made to an eye doctor if any serious eye problems are suspected during the eye examination.

Some kids may be afraid of going to the optometrist, especially when they see all the different equipment being used to check their eyes. How would you allay their fears?

When scheduling an exam for a child, parent should choose a time when the child is usually alert and happy, usually in the morning or after nap time. Before the eye exam, I would always take time to discuss with the child what will happen during the eye exam. I also use kid-friendly tools to assess their vision, to make them feel more comfortable and happy. Some of my young patients think the eye exam is a “play session”!

Care to share one of your most memorable patients/cases?

I had a patient with red eyes coming to see me because she couldn’t see well even after wearing contact lenses or glasses. After the eye exam, I told her to stop wearing contact lenses and see an eye doctor immediately. She had a corneal ulcer in one eye and mild corneal abrasion in the other eye. The patient had purchased her contact lenses online without going through a proper eye examination. The contact lenses did not fit well in her eyes. She ended up having a permanent corneal scarring and partial vision loss in one eye.

Yikes! So, what advice do you have for people looking to switch to contact lenses?

Contact lenses are classified as medical devices in Singapore. Contact lens wearers should consult a qualified optometrist or contact lens practitioner before buying contact lenses. One size fits all doesn’t apply when it comes to contact lenses. The optometrist or contact lens practitioner will perform a thorough eye health and contact lens examination and advise the wearer on the most suitable lenses that suit their needs and lifestyle.

Spending time outdoors as a child can delay or even prevent myopia as natural light may be essential for normal eye development in kids.

Let’s talk more about your role as a parent ― from the perspective of a mum, do you worry about their eyesight?

I have a 2-year-old son, Leroy, and a 4-year-old daughter, Janelle. My husband and I are nature lovers. We love bringing our kids outdoors to play. Spending time outdoors as a child can delay or even prevent myopia as natural light may be essential for normal eye development in kids. Children should spend 2 to 3 hours outdoors daily (or at least 14 hours a week). However, with our hectic lifestyles in Singapore, it is difficult to fulfil the daily quota! So, my husband and I always bring our kids to the playground, park or beach during weekends.

Do you need to take any precautions when you’re out in the sun?

Yes, spending too much time outdoors without proper ultraviolet (UV) protection can damage the skin and eyes! Children are more vulnerable to UV damage because their pupils are larger and their lenses in the eyes are clearer. Hence, UV protection is extremely important. Let your children wear sunglasses with UV protection and/or a hat. Also remember to apply sunscreen to protect the delicate skin! If your child is wearing contact lenses, contact lenses with UV blockers can provide additional UV protection as a complement to sunglasses.

What other advice do you have for parents who want to protect their kids’ eyesight?

For school-aged kids, it is important to remind them to take frequent visual breaks. Reading, drawing or playing tablet games doesn’t constitute a break. Parents can use the 20-20-20 rule: Every 20 minutes, take a 20-second break and look at something at least 20 feet [6m] away. Parents themselves should also practise this rule to prevent eye strain and eye fatigue!

Other than spending more time outdoors and taking frequent visual breaks, I also teach my kids to adopt healthy eye care habits like keeping the book at arm’s length while reading, sitting at least 2m away from the television, and eating more fruits and vegetables! Most importantly, I bring them for an eye examination at least once a year.

Photos: Iryn Gan, Instagram/United Eyecare

This article first appeared on SmartParents. Written by Melissa Tan.