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Heart disease runs in our family. My mother has heart damage from high blood pressure, and my husband's father has blocked arteries and had to have an angioplasty. I'm worried about our kids. What are the chances they will have heart disease, and how can I give them the feeling they are not overly restricted with their foods (we do take-out about once a week; we're busy), but keep them healthy?

A. Prevention is the best approach to heart disease and it is terrific that you are recognizing that prevention can never start too young! Your family history does put you at risk. A first-degree relative who has heart disease before the age of 55 is considered a risk factor. In addition, advancing age, ethnicity and gender are all risk factors. These, however, are risk factors that you cannot control. What you can control is your diet, your level of activity, avoiding excessive alcohol and making sure no one smokes. As a family, you can decide to adopt heart-healthy eating.

When you are at home, you can easily control the amount of fat, salt and butter that goes into your meals. You mention that you do eat out. It is important to read the menu and look for items that fit into your healthy eating plan. Many restaurants now have heart-healthy selections and include nutritional information. Don’t be afraid to ask how an item is prepared, and stay away from those that are fried, opting instead for those items that are steamed, broiled, poached or baked. Often a stir-fry meal will be lower in fat. Ask for your salad dressing on the side, choose whole-grain bread and stay away from the garlic bread that is dripping in butter and foods that are covered in rich sauces. It is also important to remember that smoked foods and food with soy sauce are higher in sodium. Avoid eating foods with batter.

It is important to emphasize what you can do rather than what you cannot do. Get active as a family. Encourage your children to get involved in team sports. In addition, it is important to limit your children’s time in front of the television, computer screen and video games. We know that children over the age of two should not have more than two hours of television viewing, and those under two should not have any television viewing. Excessive sedentary activity displaces time when your children should be out being active. It is also known that children who spend hours in front of screens eat more often, influenced by the advertisements they see on television. Your doctor will tell you when it is time to do screening blood work for cholesterol or glucose. At your children’s checkup they will be screened for blood pressure and have their height and weight checked. It is important for all of us to maintain a healthy BMI (body mass index). Take charge of your heart health!

My husband has a lazy eye. We have a one-year-old son, and although his eyes look fine, is there a way to tell or catch this early? Can he have his eyes tested and how often should we have him checked? Additionally, what if he has inherited this, can it be fixed?

A. The medical word for lazy eye is ‘amblyopia’. That means, according to the Hospital for Sick Children in Toronto, a decrease in fine vision, usually in one eye due to the brain’s failure to develop vision fully in that eye. Any condition that blurs the image, or makes the brain prefer one eye, can be due to many conditions. These include strabismus – when the eyes are not straight, cataracts, premature birth and unequal eye focusing. Most people look at an object and both eyes move at the same time. Somewhere between six months and nine months of age, children develop the ability to focus, coordinate their eye movement and have both eyes see at the same time. In children with lazy eye due to strabismus, both eyes cannot be used at the same time because their eyes are not pointed in the same direction. The problem becomes significant if a child prefers to just use one eye all the time. If that happens, the other eye might not develop properly. That decrease in vision is called ambylopia.

Heredity is a cause of amblyopia or strabismus. Strabismus is quite common with up to five percent of all children having some degree of it. The strabismus can be constant or intermittent. Your child can have an eye exam as early as nine months unless there is an obvious problem noted earlier. It is important to know that your child, if he does have a problem such as strabismus, will not outgrow it. It does require early detection and treatment. At the time of an examination, the ophthalmologist will examine the movements of the eye and also use a drop to dilate the eye to make sure there is no eye disease.

The goals of treatment are to preserve and improve eye vision, to straighten the eyes and to make sure the eyes work together. The doctor will determine if there is an issue with the muscles or the brain that controls the muscles.

Treatment strategies include patching the stronger eye (occlusion therapy) that will help strengthen the vision in the ‘lazy’ eye. The doctor may also prescribe eye drops to blur the vision in the healthy eye to make the other work harder or eye exercises to help make the eyes move better together. Finally, if required, there is surgery to correct the eye position that can be used along with patching and eyeglasses. Early detection is key; have a complete eye assessment performed.

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