Can you tell if your child needs glasses? Very few children complain about vision problems because they have no way of knowing that their vision is not normal. To them, it is "normal" because it is the only vision they have ever known.

Most parents are comfortable with the thought that their child's primary care physician will discover any eye problems, but unfortunately studies have shown that these providers identify as few as 25 percent of children with serious problems such as amblyopia — the partial or complete loss of vision in one eye caused by conditions that affect the normal development of vision.

However, thanks to annual screening programmes in all Government and Private Schools in Bermuda, problems can be detected early on.

Community Health Nurse, Isabell Jervis explains that every year all students from P1 through to S4 are offered a vision screening.

Students in P1 and again when they are 15 are offered health assessments and this includes having have their vision and hearing tested and having their weight, height and Body Mass Index (BMI) recorded, blood pressure screening as well as health information.

"The school nurse will then make the necessary referral as soon as the screening is complete," she adds. "Should any concerns arise with the child's weight, they are referred to the Government nutritionist. Or the parent has a choice as to who the child will see, but there are nutrition policies at schools as part of the Healthy Schools Programme." (See article on page 10)

When children start Middle School they have their eyes tested yearly and are also tested for Scoliosis of the spine (curvature of the spine) in M1.

Detecting issues with your child's vision (and hearing) early on, she says, can have a huge impact on a child's ability to not only read and follow lessons and schoolwork in general, but can affect their performance throughout life.

"You can be an excellent parent and you can still miss that your child can't see properly," she says. "When my son went for his four year old check up, he was referred to the thickest glasses (lenses) possible, and I had no idea he had vision problems. He wasn't reading at that stage, so there was no indicator that he was having problems."

And while school nurses will address any issues that might arise, Mrs. Jervis warns that they do not replace a paediatrician or general practitioner (GP).

"As a parent you need to maintain your child's annual check up as recommended by your GP and paediatrician and pay attention," she suggests. "Each day you assess your child from head to toe," If you observe any changes that concern you then speak with a health professional.

Another issue that is being addressed in local schools is Asthma. It's estimated that one in five school- aged children suffer from asthma. But thanks to a partnership between the Department of Health and the charity, Open Airways, an Island-wide asthma education program has helped to ensure that admissions to hospital have decreased by a staggering 77 percent.

School Asthma Nurse, Jennifer Wilson points out that asthma is also one of the main reasons children miss school.

Why is this figure of one in five children so high? Mrs. Wilson says no research has ever been done in Bermuda, but asthma tends to run in families and is also triggered by environmental factors.

"What I found is that the majority of children have a family history, so this would be one of the major influences in Bermuda, but we need more research," she elaborates.

Environmental triggers can include household sprays or aerosols for cleaning, plug-in air fresheners or sprays, Easter lilies, smoking, having carpets in your home, pets, old pillows, perfume, scented body lotion or shower gel, mould and indoor plants that release pollen.

Mrs. Wilson says they start working with children at preschool level and have found that the four-year-olds use the information to keep their parents informed.

"They will tell us they've told their parents not to use certain sprays, or to buy them a new pillow, so even at that age, they're using the information," she says with a broad smile.

"So you can see how it helps to expose all children to asthma education. Even though there is no stigma attached to having asthma, it also helps children to accept each other.

When it comes to going back to school, Mrs. Wilson offers the following advice:

"We want parents to inform teachers that their children have asthma. We also want parents to tell teachers what triggers their child's asthma. And most importantly, we want parents to remember to send their child's medication and spacer devices to school."

Mrs. Wilson also speaks to teachers about asthma and what to do if a child has an asthma attack. "It's a continuous process for staff," she points out. "However, there is always someone at school who knows how to give an inhaler and what to do."