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Optimizing Child Vision and Eye Health

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Children’s eyes change rapidly as they grow. Regular eye exams and parental monitoring of their children’s eye health is important, says the American Academy of Ophthalmology (AAO). The vision of infants and young children is not fully formed. In order to ensure the normal development of vision, equal input from both eyes that sends clear images to the brain is required.

Early detection of vision problems enables medical professionals to correct issues before they hinder normal development. Infants should be able to fixate on an object soon after birth, and they should be able to track movement by the time they are three months old. If a child has vision problems by the time school begins, it can hinder the learning process.

Steps to Good Eye Health

There are several steps that parents and caregivers can take to monitor their children’s eye health and ensure that potential problems are detected and treated, if needed.

Step 1: Compile a Family Eye Health History

Parents and caregivers should research whether eye diseases or conditions run in their families. This information should be shared with eye care professionals. Some common problems are:

  • Crossed eye, known as strabismus
  • Lazy eye, known as amblyopia
  • Nearsightedness

If these conditions are not treated in childhood, they could cause permanent vision loss.

Step 2: Get Regular Vision Screenings

Screenings can be done by a qualified medical professional, pediatrician, or family physician. Eye screenings include taking a case history, tests of eye alignment and visual acuity such as using an eye chart or photoscreening (taking pictures of children's eyes using a special camera), and making evaluations of overall eye heath. Medical professionals will also determine if eyeglasses are necessary, and, if needed, provide a prescription for glasses.

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The American Academy of Pediatrics and the American Academy of Ophthalmology recommends that eye screenings take place:

  • At birth, at 6 months, and again before their first birthday
  • Preschoolers between the age of 3 and 3.5
  • When children begin school
  • When children seem to have a vision problem

Vision screenings can be performed by pediatrician, family physician, nurse, or trained technician for school-age children. Tests can determine how well children can focus on near, middle, and far distances. Nearsightedness is the most common refractive error in school-age children and can be corrected by glasses.

Step 3: Watch for Signs of Eye Problems

Parents should monitor their child for signs of eye problems such as:

  • Squinting while reading or other activities
  • Excessive blinking
  • Rubbing the eyes frequently, even when the child is not sleepy
  • Tilting heads to see things such as TV or a book
  • Holding books close when reading
  • Closing one eye to see better
  • Eyes do not work in unison, may look cross-eyed
  • Being unable to fix gaze on objects
  • Poor vision in low light or at night
  • Difficulty tracking movement visually
  • Not able to maintain eye contact
  • Eyelids flutter quickly up and down or from side to side
  • Eyes bulge
  • One eye that turns in or out
  • A white or grayish-white color in the pupil
  • Redness that does not go away in a few days that is sometimes accompanied by light sensitivity and pain
  • A droopy eyelid that does not open fully
  • Itching or discomfort that could be signs of allergies

Other signs of possible eye problems:

  • Headaches, especially at the end of the day
  • Eye complaints such as tired eyes or eyestrain
  • Seeming clumsy
  • Delayed motor development

Symptoms such as pain, excessive tearing, light sensitivity, redness, and pus or crustiness could be signs of conditions such as a blocked tear duct, infections such as pinkeye, or injuries.

Step 4: Get an Eye Exam When Problems Arise

If problems are detected, children may need to see an eye specialist (ophthalmologist) who will administer a comprehensive eye exam. Eyedrops will be used to open up the pupils so that the doctor a thorough examination.

The specialist will examine the outside with a penlight to check for signs of allergies, infections, or disease. Then the specialist will check whether the pupils are round in shape, an equal size, and able to react to light. The position of the child’s eyes, lashes, and lids are looked at, and the lids are checked to see if they droop. The doctor will then ask the child to cover one eye and use the other eye to follow an object So that the medical professional can determine the child's ability to track movement.

School-age children will be placed in a darkened room so that their eyes dilate. The doctor will then use a lighted instrument called anophthalmoscope to check for a red reflex in one eye and then in both eyes at the same time. If an eye does not respond normally to light, the problem could possibly be tumors or cataracts.

There are several factors that can lead to a child having an eye exam such as failed vision screenings, screening that could not be performed or was inconclusive, or referrals by a school nurse, pediatrician or medical doctor. Certain children are also at a higher risk for eye problems.

Conditions that raise the risk of eye problems:

  • Medical conditions such as Down syndrome, juvenile idiopathic arthritis, neurofibromatosis, and prematurity
  • A family history of amblyopia, congenital cataracts or congenital glaucoma, retinoblastoma, or strabismus
  • Learning disabilities
  • Developmental delay
  • Neuropsychological conditions such as multiple sclerosis
  • Behavioral issues

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Step 5: Wear Protective Eyewear

Children can suffer serious eye damage while playing sports. It is easy to be hit with a hockey stick or struck by an elbow during basketball. The AAO recommends that children who play sports such as baseball, field hockey, and hockey wear goggles or other certified vision protective eyewear.

Be Aware

Children with vision problems may become frustrated when they cannot see the whiteboard in their classroom or the ball in gym class. Addressing these types of problems can help children to be healthier and happier at school and at home. Early intervention is the best way to avoid potential vision problems later in life.

© 2016 Carola Finch

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1 comment

RTalloni profile image

RTalloni 4 weeks ago from the short journey

Such an important topic for parents and teachers to learn about. Thanks for highlighting these steps to take for children's eye health.

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