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What is 20/20 eyesight for Pediatrics?

image 001Upwards of 80% of information processed by the brain is visual and about 67% of the brain’s electrical activity is allotted to vision. These statistics confirm the importance of healthy eyes, good vision, and sufficient visual acuity. Although commonly used as synonyms, “sight/acuity” and “vision” are two separate skills. Sight is the measure of the ability of one or both eyes to see and resolve details. It is
measured on the acuity chart and is commonly thought of as “20/20”.

Vision, on the other hand, is a skill that is progressively learned and refined through repeated and consistent interaction with our environment. Visual skills like focusing, tracking, 3D vision, and coordinated movements are foundational skills that we build upon for information identification, interpretation, and understanding. This process of interpreting visual information takes place in the brain and is called visual perception or vision. Young children learn the skills of vision and sight through environmental interactions. Immediately upon birth, infants are bombarded with constant visual stimulation.

This visual information and interpretation allows for motor development like learning to reach and grab objects, sit up, turn over, crawl, and walk. To prevent developmental delays, early detection and intervention of eye and vision problems ensure that children have the opportunity to meet their highest potential in life. Parents are instrumental in a child’s eye and vision developmental care and can advocate for their child when eye concerns are seen at home or school.

image 000Even if there are no apparent eye or vision problems, an optometrist can assess the need for spectacles for nearsightedness, farsightedness, and/or astigmatism. A timely spectacle prescription can prevent a lazy eye or permanent visual acuity loss. Additionally, eye movement, eye alignment, and anatomical health are assessed. Considering the importance of efficient visual function our modern world, a proactive approach is necessary to care for a child’s visual development. Ideally, a child’s first three exams with an optometrist should be at ages 1 year, 2.5 years, and before starting school. Through a coordinated effort with parents, schools, and pediatricians, optometrists can help identify and treat eye and vision problems early in a child’s life to prevent developmental delays.

Vision Health Specialties is equipped with five optometrists to comprehensively examine your child’s eyes. Dr. Cara Sczepanski is the newest doctor on staff and residency trained in Pediatric Optometry and Vision Therapy and Rehabilitation.

Originally published in Midland Lifestyles, January 2021 in https://www.midlandlivingmagazine.com/categories/in-print

Is Too Much Screen Time Dangerous For Your Kids?

Screen Time Pros and Cons

Whether it is homework, email, gaming, chatting with friends, searching the web or watching Youtube, kids these days seem to have an endless number of reasons to be glued to a screen. Many parents out there are wondering how bad this can be for their kids and whether they should be limiting screen time.

There are certainly benefits to allowing your kids to use digital devices, whether it is educational, social or providing a needed break. However, studies show that excessive screen time can have behavioral consequences such as irritability, moodiness, inability to concentrate, poor behavior, and other issues as well. Too much screen time is also linked to dry eyes and meibomian gland disorders (likely due to a decreased blink rate when using devices), as well as eye strain and irritation, headaches, back or neck and shoulder pain, and sleep disturbances. Some of these computer vision syndrome symptoms are attributed to blue light that is emitted from the screens of digital devices.

Blue light is a short wavelength, high-energy visible light that is emitted by digital screens, LED lights and the sun. Studies suggest that exposure to some waves of blue light over extended periods of time may be harmful to the light-sensitive cells of the retina at the back of the eye. When these cells are damaged, vision loss can occur. Research indicates that extreme blue light exposure could lead to macular degeneration or other serious eye diseases that can cause vision loss and blindness. Studies show that blue light also interferes with the regulation of the the body’s circadian rhythm which can have a disruptive impact on the body’s sleep cycle. Lack of quality sleep can lead to serious health consequences as well.

Beyond these studies, the long term effects of blue light exposure from digital devices are not yet known since this is really the first generation in which people are using digital devices to such an extent. While it may take years to fully understand the impact of excessive screen time on our eyes and overall health, it is probably worth limiting it due to these preliminary findings and the risks it may pose. This is especially true for young children and the elderly, who are particularly susceptible to blue light exposure.

How to Protect the Eyes From Blue Light

The first step in proper eye protection is abstaining from excessive exposure by limiting the amount of time spent using a computer, smart phone or tablet – especially at night, to avoid interfering with sleep. Many pediatricians even recommend zero screen time for children under two.

The next step would be to reduce the amount of blue light entering the eyes by using blue light blocking glasses or coatings that deflect the light away from the eyes. There are also apps and screen filters that you can add to your devices to reduce the amount of blue light being projected from the screen. Speak to your eye doctor about steps you can take to reduce blue light exposure from digital devices.

As a side note, the sun is an even greater source of blue light so it is essential to protect your child’s eyes with UV and blue light blocking sunglasses any time your child goes outside – even on overcast days.

The eyes of children under 18 are particularly susceptible to damage from environmental exposure as they have transparent crystalline lenses that are more susceptible to both UV and blue light rays. While the effects (such as increased risk of age-related macular degeneration) may not be seen for decades later, it’s worth it to do what you can now to prevent future damage and risk for vision loss.

 

Dry Eye in Midland? Eye Allergies are Rampant this Spring

Woman dry eye midland txIn Texas, pollen and sunshine are everywhere. While many people don’t experience many symptoms, there are quite a few of us who have eye allergies and dry eye symptoms on a daily basis. Patients with these eye conditions experience a range of symptoms from dryness, itchiness, and burning to excessive tearing or redness. While our eye doctors have treated a number of dry eye & eye allergy patients with prescription eye drops, Omega-3 supplements, and even punctal plugs for excessive tearing, occasionally, our eye doctors resort to a recent, innovative solution via custom, specialty contact lenses called scleral lenses.

Unlike conventional contact lenses, scleral contact lenses are hard, rigid contact lenses that rest on top of the sclera, the white part of the eye. Not only do scleral lenses provide amazingly clear vision, but they create a gap above the eye’s surface to make a tear reservoir. Many symptoms of dry eye and eye allergies are due to poor tear composition as well as allergens reacting to the eye. By utilizing a hard contact lens, your eyes receive a substantial layer of protection plus comfort to soothe your eye’s surface. Scleral lens wearers notice a reduction in irritation, dryness, and redness and rarely find the need for eye drops.

Speak to our eye doctors and our staff about scleral lenses and improving the quality of your eyesight, today.

Corneal Transplants & Scleral Lenses

woman wearing scleral lenses midland tx

Were you diagnosed with an irregular cornea that is affecting your vision? Although it may sound scary, this condition is not rare and treatment is often effective to achieve clear eyesight. According to estimates, over 10 million people around the globe have corneal eye disease, many of whom will undergo a corneal transplant. Our Midland, TX, eye doctors explain:

What is a corneal transplant?

In brief, your eye surgeon will remove diseased or damaged tissue in order to replace it with a healthy corneal graft. Just like all organ transplants, tissues for the transplant come from an organ donor (through a local eye bank). This procedure can be done in a variety of ways, and it’s up to your eye surgeon to determine which method is best for your case. The amount of corneal tissue that must be removed is the main deciding factor.

What is the success rate of corneal transplants?

Here are a few interesting facts for you:

  • The first human corneal graft was performed way back in 1905.
  • Nowadays, over 100,000 corneal transplants are performed yearly worldwide.
  • The cornea is the most commonly transplanted tissue in the human body.

This info should give you some reassurance about the widespread success of this procedure!

woman corneal transplant midland txAccording to a 2017 article in the Journal of Ophthalmic & Vision Research, success rates are very high – about 90% survival of the transplant after one year, and 55% after 15 years.

Will I need eyeglasses or contact lenses after a corneal transplant?

Vision correction with contact lenses or glasses is often required after a corneal transplant. In general, rigid gas permeable (GP) contacts are most effective at addressing the large amounts of astigmatism that are common after a corneal procedure, and scleral GP lens designs are very effective for many of our Midland patients. Scleral contact lenses mask any corneal surface irregularities well, and wearers attest that they are very comfortable.

How do scleral lenses help?

Scleral lenses offer a number of benefits to people who had corneal transplants. For starters, they vault entirely over your cornea and rest on the whites of your eyes (called the sclera). So no contact is made with your sensitive and fragile cornea. Also, due to their shape, they create a pocket of fluid between the lens and your eye’s surface. This buffer zone of tears can help protect your corneal tissue from any damage, as well as form a smooth surface for clear vision.

Did you have a corneal transplant? Ask our Midland eye doctors about scleral lenses for ultra-comfortable and crisp vision following the procedure.

10 Tips to Teach Children About Eye Safety

girl in funny glasses

It is important to teach your children about eye health and safety from a young age. This includes awareness about how your overall health habits affect your eyes and vision as well as how to keep your eyes safe from injury and infection. Starting off with good eye habits at a young age will help to create a lifestyle that will promote eye and vision health for a lifetime.

10 Eye Health Tips for All:

  1. Eat right. Eating a balanced diet full of fresh fruits and vegetables (especially green leafies such as kale, spinach and broccoli) as well as omega-3s found in fish, such as salmon, tuna and halibut, help your eyes get the proper nutrients they need to function at their best.
  2. Exercise. An active lifestyle has been shown to reduce the risk of developing a number of eye diseases as well as diabetes – a disease which which can result in blindness.
  3. Don’t Smoke. Smoking has been linked to increased risk of a number of vision threatening eye diseases.
  4. Use Eye Protection. Protect your eyes when engaging in activities such as sports (especially those that are high impact or involve flying objects), using chemicals or power tools or gardening. Speak to your eye doctor about the best protection for your hobbies to prevent serious eye injuries.
  5. Wear Shades. Protect your eyes from the sun by wearing 100% UV blocking sunglasses and a hat with a brim when you go outside. Never look directly at the sun.
  6. Be Aware: If you notice any changes in your vision, always get it checked out. Tell a parent or teacher if your eyes hurt or if your vision is blurry, jumping, double or if you see spots or anything out of the ordinary. Parents, keep an eye on your child. Children don’t always complain about problems seeing because they don’t know when their vision is not normal vision. Signs of excessive linking, rubbing, unusual head tilt, or excessively close viewing distance are worth a visit to the eye doctor.
  7. Don’t Rub! If you feel something in your eye, don’t rub it – it could make it worse or scratch your eyeball. Ask an adult to help you wash the object out of your eye.
  8. Give Your Eyes a Break. With the digital age, a new concern is kids’ posture when looking at screens such as tablets or mobile phones. Prevent your child from holding these digital devices too close to their eyes. The Harmon distance is a comfortable viewing distance and posture – it is the distance from your chin to your elbow. There is concern that poor postural habits may warp a child’s growing body. Also, when looking at a tv, mobile or computer screen for long periods of time, follow the 20-20-20 rule; take a break every 20 minutes, for 20 seconds, by looking at something 20 feet away.
  9. Create Eye Safe Habits. Always carry pointed objects such as scissors, knives or pencils with the sharp end pointing down. Never shoot objects (including toys) or spray things at others, especially in the direction of the head. Be careful when using sprays that they are pointed away from the eyes.
  10. Keep Them Clean. Always wash your hands before you touch your eyes and follow your eye doctors instructions carefully for proper contact lens hygiene. If you wear makeup, make sure to throw away any old makeup and don’t share with others.

By teaching your children basic eye care and safety habits you are instilling in them the importance of taking care of their precious eye sight. As a parent, always encourage and remind your children to follow these tips and set a good example by doing them yourself.

Of course don’t forget the most important tip of all – get each member of your family’s eyes checked regularly by a qualified eye doctor! Remember, school eye screenings and screenings at a pediatrician’s office are NOT eye exams. They are only checking visual acuity but could miss health problems, focusing issues and binocularity issues that are causing health and vision problems.

Red eye and dry eye syndrome are quite easily confused. Both conditions include itchy, red and dry-feeling eyes. A person who has dry eye syndrome will often think that their red, dry, itchy eyes are nothing more than something minor, like allergies, and live a long time with the severe comfort that comes with dry eye syndrome. He/she will find that, regardless of what measures are taken, the condition does not change significantly and an eye doctor must be consulted to bring relief. Fortunately, Dr. Billy Cook is very familiar with the the symptoms of dry eye syndrome and how to treat it. Dr. Cook has compiled some points of essential knowledge below, to help his patients recognize the indications of this uncomfortable and painful eye condition in a more timely fashion, so that they can prevent prolonging the pain and discomfort of this extremely uncomfortable.

Dry Eye Syndrome

Dry eye syndrome is characterized by itchy, red, dry feeling eyes that do not get better unless professional medical help is obtained. Doctors generally discuss two broad causes for dry eye syndrome. Either:

The eyes don’t make enough tears, and the eye cannot be comfortably hydrated

OR

The eye produces tears which are flawed. They often lack one or more essential parts normally included in tears to allow them to properly coat and hydrate the eye.

The leading defense against either of these forms of dry eye syndrome is a type of specialty eye drops called “artificial tears.” These special eye drops combat the uncomfortable symptoms of dry eye syndrome by imitating real tears as closely as possible. In order to do this in the best way possible, there are many different formulations of artificial tears. Each formulation addresses a different underlying cause of your dry eye. Some help to to address the issues of dry eye syndrome in which tears are lacking in quantity, and others will add one or more building blocks to your tears to help them better perform their intended function.

Red Eyes

Red eyes are generally not as worrisome as dry eye syndrome and you shouldn’t worry too much about them. In most cases, red eyes are caused by allergens or foreign substances, which can cause your eyes to become irritated. Small blood vessels throughout your eyes then become inflamed and enlarged, becoming much more visible and turning your eyes a reddish hue. This is where the term “red eyes” comes from.

Many times, red eyes will heal up and return to normal without any medical attention at all. A not of caution, however: The great number of conditions that can cause dry eyes makes it very hard to know exactly what the cause may be sometimes. If your red eyes are accompanied by a high fever, headache and/or a great deal of eye pain, go to the doctor immediately. This note aside, red eyes are almost always minor and should not cause anxiety unless accompanied by these additional symptoms.

Even with a brief but comprehensive explanation such as this, it can sometimes be hard to tell the difference between these two similar looking conditions. If you feel your red eyes may be something more, come see Dr. Cook at Vision Health Specialties today.

Preventing Age-related Macular Degeneration

dad riding bike with daughter

February is AMD and Low Vision Awareness Month in the United States, and it?s White Cane Week in Canada. Age-related Macular Degeneration (AMD) is a leading cause of vision loss in adults aged 50 and older. Awareness about the disease, the risk factors

and prevention are critical, even for younger generations because taking care of your eyes while you are young will help to reduce the risks later on in life.

Understanding AMD

AMD is a disease that damages the macula, which is the center of the retina responsible for sharp visual acuity in the central field of vision. The breakdown of the macula eventually results in the loss of central vision and can occur in one eye or both eyes simultaneously. While AMD doesn?t result in complete blindness, the quality of vision is severely compromised leading to what we refer to as ?low vision?.

The loss of central vision can interfere with the performance of everyday tasks such as driving, reading, writing, cooking, or even recognizing faces of friends and family. The good news is, there are many low vision aides on the market now that can assist in helping you to perform these tasks.

There are two types of AMD, wet and dry.

Dry AMD is the most common form of the disease. It is characterized by blurred central vision or blind spots, as the macula begins to deteriorate. Dry AMD is less severe than the wet form, but can progress to wet AMD rapidly.

Wet AMD is when abnormal blood vessels begin to grow under the retina and leak fluid and blood into the macula, causing distortions in vision. Wet AMD can cause permanent scarring if not treated quickly, so any sudden blur in vision should be assessed immediately, especially if one is aware that they have AMD.

Are You at Risk?

The biggest risk factor for AMD is age. Individuals over 60 are most likely to develop the disease however it can occur earlier. Additional risk factors include:

  • Smoking: According to research smoking can double the risk of AMD.
  • Genetics and Family History: If AMD runs in your family you are at a higher risk. Scientists have also identified a number of particular genes that are associated with the disease.
  • Race: Caucasians are more likely to have AMD than those from Hispanic or African-American descent.
  • Lifestyle: Obesity, high cholesterol or blood pressure, poor nutrition and inactivity all contribute to the likelihood of getting AMD.

Prevention of AMD:

If you have risk factors, here is what you can do to prevent or slow the progression of AMD:

  • Regular eye exams; once a year especially if you are 50 or over.
  • Stop smoking.
  • Know your family history and inform your eye doctor.
  • Proper nutrition and regular exercise: Research indicates that a healthy diet rich in ?Eyefoods? with key nutrients for the eyes such as orange peppers, kale and spinach as well as regular exercise may reduce your risks or slow the progression of AMD.
  • Maintain healthy cholesterol levels and blood pressure.
  • Dietary supplements: Studies by the National Eye Institute called AREDs and ARED2 indicated that a high dosage of supplements of zinc, vitamin C, vitamin E and lutein may slow the progression of advanced dry AMD (it is not recommended for those without AMD or early AMD). Speak to a doctor before taking these supplements because there may be associated risks involved.
  • Wear 99% -100% UV-blocking sunglasses.

The first step to eye health is awareness. Help us to spread the word about this debilitating disease and the importance of choosing a healthy lifestyle.

Sometimes a person is unable to produce enough tears or their tears do not possess the right qualities to keep eyes healthy and comfortable. This can cause a consistent lack of sufficient lubrication and moisture on the surface of the eye, known as dry eyes.

Normally, the eye constantly lubricates itself with tears by producing them at a slow and steady rate, keeping itself moist and comfortable. Usually these tears consist of three layers, an oily, a watery, and a mucus layer. Each layer has a specific role in lubricating your eyes. The oily layer is outermost. It’s main purpose is to slow evaporation of the tear. The watery layer is in the middle. This makes up the majority of what a person normally thinks of as tears. This layer cleans the eye and helps to wash away small foreign objects and particles. The inner layer consists of mucus. This mucus allows the watery layer to stick to the eye and spread evenly over the eye in order to keep it lubricated. In a person with dry eyes, either hormonal changes, side effects from medication or some other factor causes the eye to either not produce enough tears, or leave out parts of the tear that make proper lubrication possible.

Dr. Billy Cook, of Vision Health Specialties in Midland, Texas explains, “Symptoms of dry eyes include stinging or burning in the eyes, scratchiness, and excessive irritation from smoke or wind. Although it may sound counter-intuitive, the eyes’ response to the consistent irritation caused by dry eyes may also cause a person to experience excessive tearing. In this case, the eye is attempting to flush and lubricate itself by producing more tears, but is unable to do so successfully due to the rate of evaporation or inability to spread the tears properly.”

Although dry eyes are not always curable, your optometrist may prescribe artificial tears to help with some of the symptoms. Artificial tears are lubricating eye drops that may help with dry, scratchy feeling eyes. Different artificial tears work in different ways. Some help replenish parts of the tear that your eyes are not producing on its own, others help to produce more tears overall. Your eye doctor will assist you to choose which will help you most. Dr. Cook cautions, however, “These artificial tears should not be confused with eye drops that are advertised to ‘get the red out.’ These eye drops may indeed reduce the appearance of redness in your eyes, but this is accomplished by making the blood vessels in your eyes smaller rather than actually lubricating your eyes. As such, these drops can sometimes actually make your symptoms worse. One should also be aware that if you wear contacts, some eye drops require you to take them out before using the drops and wait 15 minutes or more before reinserting your contact lenses.”

Some cases of dry eyes are seasonal, such as those which occur as a result of cold, dry winter air. In this case, your eye doctor may recommend wearing sunglasses or goggles when outdoors to reduce your eyes’ exposure to the sun, wind and dust. For indoors, your optometrist may recommend an air cleaner and humidifier to take dust out of the air and add moisture to air which is too dry.

Studies have also shown that nutrition may have a part in helping to relieve some symptoms of dry eyes. Your eye doctor may recommend nutritional supplements such as omega-3. Good sources of omega-3 fatty acids are cold-water fish, cod, herring and salmon, as well as flaxseed oil. Mild dehydration can make symptoms worse too, so be sure to drink plenty of water, 100 percent fruit and vegetable juices and milk.

The most well-known part of a comprehensive eye exam is the basic visionblog_photo_12_31_15 test. When you have a general vision test, one of the main conditions the eye care practitioner is checking for is a refractive error. A refractive error means there is an abnormality in the shape of the eye, changing the eye’s ability to focus light directly onto the retina.This causes blurred vision and can usually be corrected by wearing prescription eyeglasses, contact lenses and possibly, alternate treatments such as vision therapy, ortho-k, LASIK or refractive surgery such as LASIK.

The term, “refractive error” refers to a problem with the process of refraction that is responsible for sight. Normally, light rays that enter your eye are refracted or bent through the cornea and the lens, and ultimately converge or are focused onto a single point on the retina. From the retina, messages are sent through the optic nerve to the brain which then interprets these signals into the image that we are seeing.

In order for this process to work effectively, the anatomy of the eye including the length of the eye and the curvature of the cornea and the lens must be just right to be able to focus the light onto the retina. When this is not the case, a refractive error will occur.

There are several different types of refractive errors, depending on which part of the eye is affected, and it is possible to have multiple refractive errors at the same time:

Myopia or nearsightedness:
In myopia the length of the eyeball is too long which results in light coming to a focus in front of the retina, rather than on the retina. This allows the individual to see well when objects are close but not clearly when looking at objects at a distance.

Hyperopia or farsightedness:
Hyperopia is when the eyeball is shorter than normal and can result in near objects being blurry. However, people experience hyperopia differently. Sometimes distant objects are clear while other times people may experience overall blurred vision near and far or no problems at all. In children particularly, the lens may accommodate for the error allowing for clear vision but may cause fatigue and sometimes crossed eyes or strabismus. Hyperopia causes eyestrain or fatigue especially when looking at near objects for a period of time. Often people with 20/20 vision may still need glasses at their desk to relax their eyes and improve concentration.

Astigmatism:
Astigmatism is usually the result of an irregularly shaped cornea (although it can sometimes also be due to a misshapen lens). The cornea, which is normally round, is more football-shaped in an eye with astigmatism, resulting in multiple focus points either in front of the retina or behind it (or both). People with astigmatism usually have blurred or distorted vision to some degree at all distances, near and far.

Presbyopia:
Presbyopia is an age-related condition which usually begins to appear sometime after 40. As the eye begins to age, the lens stiffens and can no longer focus clearly on objects that are close.

It’s important to note that presbyopia is often confused with hyperopia, as both cause problems focusing at near distances. However, high hyperopia can also cause blur at far distances as well, especially in dim lighting, and depth perception problems can result in motor vehicle accidents. In these instances people with hyperopia could use glasses at any distance.
If you are having trouble seeing, it is important to have an eye exam to determine the cause of the problem and to effectively correct your vision. Even if your vision is fine, you should schedule a routine eye exam on a regular basis to ensure that your eyes are healthy and that any potential problems are caught early.

Protective Sports Eyewear is a Serious Matter

dad riding bike with daughterThere are thousands of eye injuries a year related to sports. According to the National Eye Institute eye injuries are the leading cause of blindness in children in North America and most injuries occurring in school-aged children are sports-related. Further 99% of sports-related eye injuries can be prevented simply by wearing protective eyewear.

Sports injuries aren’t just a result of contact sports. Any sport can pose a danger especially those that involve balls, bats rackets or even elbows. It’s up to parents, teachers, coaches and league administrators to make protective eyewear a mandatory part of any sports uniform. This includes safety glasses or goggles, helmets with built in eye shields, or eye guards, depending on the sport.

Prescription Sports Eyewear

For athletes that wear prescription eyewear or contact lenses, sports eyewear plays an additional role. Many athletes choose to forego eyewear during play because of the inconvenience it causes, however this impairs their vision and ultimately affects their performance ability. Wearing prescription sports eyewear or wearing non-prescription goggles over their glasses or contacts not only serves to protect the eyes, but it allows them to see better and increases performance. It’s very important to note that standard prescription glasses or sunglasses do not protect the eyes from an impact and could possibly cause greater harm if the lenses or frames are damaged during play.

How to Select The Right Protective Sports Eyewear

Protective eyewear is made of special materials that are impact resistant such as polycarbonate or Trivex. Polycarbonate and Trivex lenses for outdoor use also have UV protection to protect the eyes from the sun, and can be made with added tints just like built-in sunglasses. It is a good idea to make sure that your lenses include a scratch resistant coating so that natural wear and tear don’t cause reduced visibility. Athletic eyewear frames are usually made from polycarbonate also, or from strong plastic, and often have padding on the forehead or nose to enhance comfort and fit.

Especially in children who are growing, it is critical for protective eyewear to fit well, for optimal safety and vision. To check that the glasses fit properly make sure that the internal padding rests comfortably on the face and that the eyes are centered in the lens area. If the child complains that they are too tight or you can visibly see that they are too loose, it may be time for a new pair. Also take into consideration whether the child will be wearing a hat or helmet to make sure that the goggles or glasses fit comfortably inside the gear.

Depending on the sport, the type and design of the eye protection varies, so be sure to tell your eye care professional what sport you play so he or she can find the best type of eyewear to keep your eyes safe.