Vision Changes in Teenagers: Eye Conditions and Prevention

Adolescence is a time in a child’s life when many changes occur in the body. Some of these changes are more apparent, such as a growth spurt. However, you might not realize that the eyes develop significantly during this period. Changes in the eye may be less obvious but are essential to learning. In this article, we will review some typical eye problems teenagers deal with and tips on preventing these issues.

Physical and mental changes in adolescence

Adolescence is otherwise known as the teenage years and spans from 13 to 18 years of age. During this time, the body undergoes rapid development. Puberty, which is when a child becomes sexually mature, occurs during adolescence. The process begins as early as six and continues into the early 20s. The increased production of sex hormones (estrogen, testosterone, and progesterone) results in biological changes. Noticeable changes typically occur between ages eight to 13 but vary from person to person.

Physical changes that occur in girls include breast development, pubic, underarm, and leg hair growth, menstrual periods, and a growth spurt.

While changes in boys include enlargement of testicles and scrotum, followed by the penis, pubic, underarm, and leg hair growth, voice changes, nocturnal emissions (wet dreams), and a growth spurt.

Teenagers also experience differences related to psychological, cognitive, and social development, which may include mood swings, exploring sexuality and relationships, developing a sense of identity, gaining independence, increasing the ability to problem solve and think abstractly, and seeking peer acceptance and strong friendships.

When people think of puberty, they primarily think of these changes. However, the eyes also develop rapidly during this time.

Eye changes during adolescence

Childhood is a crucial period for visual development, including the teenage years. Just like the body, the eyes undergo a growth spurt too. On average, the axial length (eyeball length) is 16.8 mm in newborns and increases to 23.6 mm around 20 years of age. Much of this growth occurs shortly after birth and during puberty.

Other visual skills that continue to mature in adolescence are:

• Visual acuity. How clearly you can see at a distance and up close.
• Accommodation. How well the eyes can change and maintain focus between objects, such as looking from a book to the chalkboard.
• Eye-tracking. The eyes’ ability to track a moving object or follow words on a page.
• Visual perception. How the brain processes and makes sense of what you see.
• Binocular vision. Both eyes must coordinate as a team to have good depth perception, such as in sports.

Several conditions can affect the normal development of these skills, which we will review below.

Eye conditions in adolescents

Some common eye issues in teenagers are:

• Refractive error. This includes myopia (nearsightedness), hyperopia (farsightedness), and astigmatism (irregularly shaped eyeballs). Refractive errors cause your eye to have difficulty focusing. Myopia is increasing steadily among teenagers, with a jump from 14% of children 5–7 years of age to 59.0% of adolescents 17 to 19 years of age.
• Amblyopia. Commonly known as lazy eye, amblyopia is poor vision resulting from abnormal eye development. Amblyopia can result from strabismus (eye turn), refractive error, droopy eyelid, or cataract (cloudy lens in the eye). Although these conditions are typically diagnosed in early childhood, detection may be delayed without routine eye exams.
• Digital eye strain (DES). Occurs after extended viewing of computer screens, phones, tablets, and other devices that emit blue light. DES encompasses the vision and dry eye symptoms, including blurry vision, double vision, headache, eye fatigue, eye irritation, and eye redness. As teenagers spend more time on screens for school and social activities, DES is likely to increase among this population.
• Sun damage. The sun’s ultraviolet light damages eye tissue. Children and teenagers are more vulnerable since their pupils are larger, and the natural lenses are clear, which allows ultraviolet light to reach the retina (tissue in the back of the eye). The front of the eye is at risk for photokeratitis (sunburn) and pinguecula (bump on the white of the eye).
• Eye infection. As teenagers begin wearing contact lenses, hygiene and eye infections become a concern. Common infections include keratitis (painful ulcer on the cornea) and conjunctivitis ('pink eye'). These infections may be related to bacterial buildup if contact lenses are not cared for properly.
• Eye trauma. Over 60% of all eye injuries occur in people 16 years or younger, with 11–15-year-olds comprising a large portion of injuries. About 25% of pediatric eye injuries arise from sports or recreational activities. Other common causes include accidental blows and falls. Eye trauma: Over 60% of all eye injuries occur in people 16 years or younger, with 11–15-year-olds comprising a large portion of injuries. About 25% of pediatric eye injuries arise from sports or recreational activities. Other common causes include accidental blows and falls.

Many eye conditions can be treated or improved with early detection, while others are preventable by taking proper precautions.

Preventing eye problems in teenagers

Keeping teenage eyes healthy starts with building good habits. Here are some ways to protect their eyes:

• Wear prescription glasses. If an eye doctor prescribes computer glasses or other corrective eyewear, it is vital to use them as directed. Glasses correct refractive errors, improve amblyopia, and reduce DES. The doctor may recommend blue light protection or anti-glare coating on the lenses to improve comfort while viewing a screen.
• Use protective eyewear. For active teenagers, sports goggles are essential as regular glasses do not provide adequate protection for physical activities. They are impact-resistant and must meet safety standards for a particular sport. Higher-risk activities include basketball, baseball, racquetball, hockey, martial arts, and wrestling.
• Wear sunglasses and hats outdoors. Sun protection is often overlooked by younger people. Sunglasses with 100% ultraviolet protection should be worn outdoors, even on cloudy days. A brimmed hat blocks additional sunlight from entering your eyes.
• Practice contact lens hygiene. Teenagers can use contact lenses safely with the proper regimen. These include washing the hands thoroughly before touching the eyes, disposing of the contacts according to a set schedule, cleaning the lenses with a disinfecting solution, and not sleeping or swimming in them.
• Exercise the 20-20-20 rule. This routine involves taking breaks from the screen every 20 minutes, for at least 20 seconds, by looking at an object at least 20 feet away (such as out the window). Looking into the distance allows the eyes to relax their focus and minimize DES. An easy way to remember is to set a timer for 20 minutes.
• Receive regular eye exams. An eye doctor can diagnose vision issues and eye diseases before permanent vision loss occurs. They can also recommend specific glasses, contact lenses, and protective eyewear for activities teenagers participate in.

Transitioning from childhood to adulthood is difficult for many adolescents, but maintaining eye health does not have to be one of those challenges. The earlier eye problems are identified, the earlier they can be treated to ensure healthy vision well into adulthood!