Streff Syndrome. Kids Anxiety and a Link With Eyesight

When my daughter, Anika, was going through some anxiety and learning issues last year, her Year 1 teacher let me know that she was complaining about her eyesight.

I’m afraid to say that at the time it felt like ‘one more thing’ on my list of things to deal with (you know, the normal parent list and the big work/life juggle) and as David and I had decent eyesight until our 40’s I almost dismissed it.

However… I started going through the process of checking everything to get our happy little girl back.

We were extremely blessed to have encountered some fantastic professionals through this journey: Her very caring teacher Mrs Jenkins and the Mini Lit program at Oyster Bay Primary School; her GP Dr Richard Nguyen at Kareela Family Practice who spent almost an hour with us in her first session and opened my eyes to a few things; and her brilliant optometrist, Celine Zhang from Eyecare Plus in Kareela.

As a bit of background, Anika was complaining of stomach ache at bedtime and every morning; not sleeping well; very unhappy at school; often in sick bay and even doing little ‘vomits’ at school and at home. After seeing Dr Nguyen I took her to Eyecare Plus. At the end of the examination Celine said that although technically her eyes were fine, she asked what else was going on.

I have interviewed Celine to help shed some light on what she was diagnosed with… Streff Syndrome.

Streff Syndrome

Tell us a little bit about you.

My name is Celine Zhang and I’m a Behavioural Optometrist with a strong interest in children’s vision. I’ve worn glasses since I was a child so I understand the importance of having good vision in the classroom. In my spare time, I volunteer for a charity called Eyes4Everest, who provide eyecare to those in need in the Everest region.

You specialise in children’s optometry. Where did you train?

I’m an optometrist with a special interest in children’s vision and vision therapy. I hold a Bachelor of Optometry/Bachelor of Vision Science from UNSW and a Specialist Certificate in Management of Paediatric Patients (Optometry) from the University of Melbourne. Vision therapy is another interest of mine and I have completed various courses from a US based curriculum.

Is it best for kids to see a specialist or will any optometrist do?

Much like a paediatrician, optometrists who have a special interest in children’s vision have a child-friendly approach and testing equipment to make the eye test pleasant and stress-free.

In Eyecare Plus Kareela, we are child-friendly behavioural optometrists who know that vision is more than just checking if you can see clearly.

Behavioural Optometrists have a special interest in vision beyond the eyeball. We don’t only assess for clarity of vision and ocular health, but also functional visual skills such as eye tracking, eye focusing, eye teaming, and visual information processing. We take a holistic approach to ensure that your child has the strength and stamina to keep up with all the visual demands placed on them.

You can find Behavioural Optometrists near you here.

In our appointment you picked up on some anxiety issues through her eyes! Tell us a bit more about the eye and what it can show us.

Eyes offer a glimpse into your overall health. They really are a window to your soul! Optometrists can see more than just vision problems. In a comprehensive eye examination, we can detect a range of health conditions including diabetes, high cholesterol, hypertension, autoimmune disorders and even brain tumours. 

I had never heard of Streff Syndrome before… Are many children affected? What were the symptoms that you saw?

Streff Syndrome is a rare condition. It is usually seen in children (or adults in some cases) who are going through periods of emotional or visual stress. The child may have difficulty describing what they are experiencing. Streff Syndrome is real and measurable.

It is a condition which is mainly exhibited in young children going through periods of emotional or visual stress. The visual system, while still active, is no longer controlled by the child when they are under increased levels of stress. Focusing becomes difficult, a tunnel vision effect in a child’s field of view arises, and it becomes hard for their pupils to function adequately during different light conditions.

Streff syndrome is not an abnormality with the physiology of the eyes. Rather it has been associated with the brain and how it processes what you see. As an optometrist, we measure reduced or blurred distance and near vision, poor eye teaming and eye movement capabilities, visual field loss and a reduction in focusing. The eye itself is healthy with no issues with the structures of the eye.

Tell us about the ‘magic glasses’; Do they always work?

The main clinical treatment of Streff syndrome is the use of glasses with a low prescription, worn all the time. This usually helps the visual system relax, re-engage and organise visual information efficiently. Most patients show a dramatic improvement with the appropriate lens prescription. Some patients also require some vision therapy alongside the spectacles. We also often facilitate referrals to other healthcare professionals to manage the issues that may have caused the Streff Syndrome.

Which are your favourite kids glasses from your Eyecare Plus store?

When I got glasses as a child, there was a very limited range – mostly oval, metal frames a’la Harry Potter. Glasses have become a trendy fashion statement and my experience is that most kids want glasses, whether they need them or not!

At Eyecare Plus Kareela, we have handpicked children’s frames that are durable, safe, stylish and fit well. Some of my personal favourites include:

The Outcome

Since wearing her ‘magic glasses’ Anika was remarkably better within a week and has been ever since. Everything from the tummy ache going, to becoming her usual self at home and at school; even sleeping better. She still wears her glasses a lot of the time (although not as regularly as the first few months) and we absolutely got our happy little girl back without needing to see a psychologist or pediatrician.

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Thanks to Celine for taking the time to answer these questions. Do you have an experience with Streff Syndrome? Let us know below!