Keeping an eye on your child’s vision

Detecting eye problems at an early age is crucial to prevent vision complications, says orthoptist Celine Pace
Children should have a first thorough eye check at the age of three and again at around five to six years before first grade. Photo: Shutterstock.com

Parents may wonder if their child has an eye problem or when they should schedule their first eye test.

Newborn babies have their eyes screened by paediatricians shortly after birth and again as part of their routine health and development review at the Well Baby clinics at the local health centres. However, their first thorough eye check should be at three years of age and again at around five to six years, just before entering first grade. Of course, if at any age, you notice your child’s eyes change in any way or if you notice any unusual signs or symptoms, seek advice.

Early identification and intervention of a child’s vision problem is crucial, particularly while their visual system is still developing (up to about the age of seven or eight.) According to the American Optometric association, five to 10 per cent of preschoolers and 25 per cent of school-aged children have vision problems that can cause permanent sight loss if left untreated.

Physical symptoms such as misaligned eyes, poor eye tracking, eyes that flutter or shake, cloudy pupils, bulging eyes, asymmetrical pupil sizes or eyelids are all signs of visual problems a parent should look out for.

Other symptoms such as chronic tearing, redness, swelling, squinting and frequent eye rubbing are also telling signs of visual troubles.

Changes in your child’s behaviour can also be an indication he/she is experiencing visual difficulties. For instance, complaining of frequent headaches, sitting close to the TV set, poor hand-eye coordination or being unusually clumsy are a few indicators. Children with developmental delay should also be monitored.

“Changes in your child’s behaviour can also be an indication he/she is experiencing visual difficulties”

Vision problems may have a significant impact on a child’s development and education; for example, a child who is unable to see print or a whiteboard can become easily frustrated, leading to poor academic performance. Vision loss can cause lifelong disability and can also limit the kind of job your child might pursue as an adult.

Some of the most common eye diseases in children include:

  • Lazy eye (amblyopia) is a condition in which the vision in one eye is decreased. This condition is one of the hardest to detect because the child is not aware vision is compromised. If left untreated, the brain starts to ignore the image coming from the weaker eye and stops developing the nerve connections leading to it. By the age of nine, the vision loss in the weaker eye becomes permanent. However, if diagnosed early enough, the condition is reversible and the vision would be saved.  It is most commonly corrected with glasses and eye patching to strengthen the weaker eye.
  • Misalignment of the eye (strabismus) happens when an eye drifts or appears crossed in respect to the other eye. This may be seen all the time or intermittently. Occasionally the child might tilt his/her head to align their eyes. This condition affects three to five per cent of children. It is usually corrected with glasses, eye exercises and/or occasionally surgery.
  • Short-sightedness (myopia) is when makes distant objects are blurred and near ones are seen clearly.
  • Long-sightedness (hyperopia) is when distant object are clear and near ones blurred.
  • Droopy eye (ptosis) occurs when a drooping eyelid blocks a child’s vision, affecting the eyes’ normal development.

Specifics of how your child’s eyes are examined depend on the child’s age and communication abilities. Your child does not need to know the alphabet in order to undergo an eye test. Objective techniques are used on non-verbal or shy children.

Usually, a check-up will include a case history, vision testing, determination of whether any glasses are needed, testing of eye alignment and eye health evaluation. Occasionally, the practitioner will need to put drops in your child’s eye to widen their pupils in order to examine their eyes more thoroughly.

In conclusion, it is highly recommended that every child has their first thorough eye test in their pre-school years in order to identify any visual problems early and obtain the best possible visual outcome. If you have any concerns or are in any doubt, make an appointment with an eye specialist to put your mind at rest. 

Read more Child articles here.

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