Thank you

We want to take this opportunity to say thank you, for all your support. The last year has had some uncertain times! As our appointment book continues to be busy, as we continue to dispense glasses and sunglasses, and to help people who bring their eyecare concerns to us, we just want to acknowledge we do appreciate your support. Here’s how we see it. When you come to McDonald Adams:

• You take advantage of our knowledge

• You keep money in our local economy

• You purchase from experienced, trained, eye care experts

• You help us create local jobs

• You choose products we understand and know work

• You support our small business

Thank you.

Magnifier - Use Your Phone!

Here is a handy tip about your phone - you can use it as a magnifier.

After a year of scanning the Covid QR code we are used to having our phones at the ready. So next time you are at the supermarket without your glasses, trying to read the fine print on a label give it a go.

For people with good vision, enlarging things is not a vital need. But knowing how to access a simple tool can be handy to share with people who may be struggling. Many of the excellent digital devices available to help people with Low Vision can be tricky to master if and when you actually can’t see well. Using Siri on your phone is another example of helpful technology. Setting up to call family members on a verbal instruction can be helpful if you struggle to see the number on a phone. For an older person who is not familiar with using a smart phone mastering the technology to begin with can be a barrier.

So there’s no time like the present to give it a try. Look under Settings in the Accessories folder to install the magnifier.

Priya Patel - Extern Optometry Student 2021

Priya, a final year optometry student is completing part of her Auckland University externship in the practice during June. We invite you to make an appointment with Priya. Claire and Sally will be supervising and reviewing Priya’s clinical findings. 

Please allow an hour and note the examination fee will be reduced to $70. We are delighted to be able to mentor and support final year students.

Sharing Our Experience and Tips for Progressives Lenses

Here are McDonald Adams we have a team who have successfully worn progressives lenses. Read our comments and advice.

Alison: I love my progressives - from my very first pair I just put them on and wore them comfortably. I love not having to change between two pairs of glasses, and find today’s coatings very beneficial - especially the anti-reflection and blue coating for digital work (I look at a screen most of my work day). Highly recommend progressive lenses - they make wearing glasses easy!

Sally: Settle your glasses down on top of your ears and nose, this way you will be getting the best vision through your progressive lenses. Remember to look straight ahead for far away, then just drop your eyes (not your chin) to look down for reading. Practice in front of TV with an easy book in your lap for your first evening or two.

Claire: A quick check revealed I have now tried 17 different progressive lens designs! These range from fully customised lenses through to the most widely prescribed progressive designs. While every person’s experience is unique, I can honestly say I don’t notice that I am wearing progressives. The field of vision is so good now that there is no apparent blur to the side at any distance.

Katrina: Progressives are easy, even with my challenging prescription. They cater for all ranges of vision from driving , looking at the speedo and then working on the computer! I have found that the elite customised designed lenses give me maximum clarity though all areas of the lens..

Guidelines for children and screens

Most of us probably think that small children spending a lot of time looking at screens is probably not a good idea. But is there any evidence to back this up? Frustratingly little. But there are very helpful guidelines available, and we should be promoting these recommendations.

As optometrists, we are often asked by parents, what are the implications of screen time on vision development. Now we can refer to the WHO recommendations.

At a glance these recommendations say infants less than one years of age should have no screen time. For one year olds, sedentary screen time (such as watching TV or videos, playing computer games) is not recommended while for those aged 2 years, sedentary screen time should be no more than 1 hour; less is better. Older children of three-four years are recommended to have no more than 1 hour of sedentary screen time; and again less is better.

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Children under 2 years of age No screen time. Excessive screen time reduces language development and increases the likelihood of childhood obesity.

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Children 2-5 years Children who are toddlers and pre-schoolers should have a maximum of 1 hour of screen time a day. Higher rates of screen time are associated with less play, poorer social skills, slow language development and increased risk of obesity.

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Children 5-17 years Should be limited to 2 hours of recreational screen time per day. Children are now using screens more during their education, so limiting screen time during entertainment is important. When families pay attention to their media consumption and parents monitor their children’s digital access, the amount of screen time reduces along with positive improvements in sleep and school performance.

The recommendations made by WHO are echoed by New Zealand’s version: Sit less, Move More, Sleep Well: Active play guidelines for under-fives.

Is screen time harming children's eyesight?

There has been a significant onslaught in the use of technology by our children and teenagers, as the world around us becomes more reliant on screens, all of the time. Children are accessing screens at school, around the home, in the community and for personal entertainment at younger and younger ages.

At the same time, there has been an unprecedented increase in myopia (short sightedness) in children, with higher numbers and earlier age of onset. So is this correlation or causation? It’s seems sensible to blame the screens, but nothing is ever that simple. Increased screen time can be associated with more near work, more indoor time and less outdoor exposure.

Is myopia caused by screen time, or are they co-existing features of the modern visual environment? The increase in myopia rates occurred before the saturation of screens in society, with rates of short sightedness in East Asia increasing before the technology took hold. (1)  Analysis has showed no significant association between screen time and myopia. But even when no statistical association was found, children who were myopic spent more time using screens.

We do know there is an association that children whom spend limited time outdoors, and more time at near have increased rates of myopia, and it may simply be that the screens have replaced other near work modes. (1) This could be supported by the fact that whilst screen time has dramatically escalated in children, the myopia rates, whilst increasing, have not exponentially exploded.

Part of the challenge to figure this out scientifically, is that to ascertain device usage, most studies use surveys and questionnaires. These immediately compromise the data, and are likely not as reliable as objective measures. Who wouldn’t down play the amount of time they spend on social media! A novel survey used data usage as an objective measure of time spent on the device, and correlated that to frequency of myopia.(2) They found a significant relationship between increased data usage and myopia - the myopes used almost twice as much data per day as non-myopes. As a cross-sectional study, the authors were unable to measure the impact of screen time on myopia progression, but they did find that more data usage co-existed with higher myopic refractive error.

How much are children actually looking at screens?

A Philadelphia study suggested that at age four, half of children had their own TV and three-quarters had their own mobile devices. (3) The data usage study suggested that teenagers dedicate double the time to smartphone use than they do to all other near work, and each younger age group spends more time in bed on the devices than the one before them. (2) I can confirm this one from personal observation in my own home!  A 2011 study suggested 47% of children were spending more than two hours a day on screen time for entertainment, (4) and by 2019 that number had skyrocketed to 98% in the US! (5)

What advice should we be giving you?

When families pay attention to their media consumption and parents monitor their children’s digital access, the amount of screen time reduces along with positive improvements in sleep and school performance.(6)  We know there is a protective effect of outdoor time on the onset of myopia, so it is sensible to recommend outdoor time away from any near activities.

The World Health Organization recommends at least 60 minutes of moderate to vigorous physical activity for school aged children per day, yet a UK survey found that three-quarters of UK children aged 5-12 years spend less time than this outside - which is less time spent outside than prison inmates! Shockingly, 20% of the children surveyed never play outside regularly. When it comes to myopia prevention, though, it’s not the physical activity that is the crucial element, it is likely the light exposure (7) - so to combine both benefits, this physical activity time can be undertaken outdoors.

Our advice:

• Reduce screen time: the Australian Department of Health and the American Academy of Paediatrics recommend less than two hours per day of leisure screen time for school-aged children

• Get at least 60 minutes of moderate to vigorous intensity physical activity: recommended by the World Health Organization for children aged 5-17 years

• Be sun safe and protect from UV when outdoors: especially here in New Zealand.

Need more ideas and help? Check out these brilliant resources.

Close Work and Screen Time for Kids

How Much Time Should My Child Spend Outdoors

References.

1 Lanca, C. & Saw, S. M. The association between digital screen time and myopia: A systematic review. Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians 40, 216-229, doi:10.1111/opo.12657 (2020)

2 McCrann, S., Loughman, J., Butler, J. S., Paudel, N. & Flitcroft, D. I. Smartphone use as a possible risk factor for myopia. Clinical and Experimental Optometry n/a, doi:10.1111/cxo.13092

3 Kabali, H. K. et al. Exposure and Use of Mobile Media Devices by Young Children. Pediatrics 136, 1044-1050, doi:10.1542/peds.2015-2151 (2015)

4 Maniccia, D. M., Davison, K. K., Marshall, S. J., Manganello, J. A. & Dennison, B. A. A Meta-analysis of Interventions That Target Children's Screen Time for Reduction. Pediatrics 128, e193-e210, doi:10.1542/peds.2010-2353 (2011)

5 Madigan, S., Browne, D., Racine, N., Mori, C. & Tough, S. Association Between Screen Time and Children’s Performance on a Developmental Screening Test. JAMA Pediatrics 173, 244-250, doi:10.1001/jamapediatrics.2018.5056 (2019)

6 Gentile, D. A., Reimer, R. A., Nathanson, A. I., Walsh, D. A. & Eisenmann, J. C. Protective effects of parental monitoring of children's media use: a prospective study. JAMA Pediatr 168, 479-484, doi:10.1001/jamapediatrics.2014.146 (2014)

7 Read, S. A., Collins, M. J. & Vincent, S. J. Light Exposure and Eye Growth in Childhood. Investigative ophthalmology & visual science 56, 6779-6787, doi:10.1167/iovs.14-15978 (2015)