10 September 2019
The development of vision problems
It can be difficult to know that your child is struggling with their vision because they may not even be aware themselves. If the problem is something which has been present from early in their life, they might just take it as the norm and not give you any indication that something is wrong. Babies can only focus on distances around 10 inches from their faces for their first couple of months, with their eyesight starting to improve at 3-4 months old. They begin to develop some sort of depth-perception and coordination over the next year, but vision problems aren’t usually obvious until the toddler years, when children start playing with more complex toys and interacting with their peers.
The most common issues that children face with their vision generally manifest themselves between the ages of 18 months and 4 years old. These come in the form of amblyopia (a lazy eye) and strabismus (crossed eyes). We have previously written about the differences between these two conditions and how they can be treated. Ultimately, amblyopia is a problem with a person’s visual acuity and can develop as a result of strabismus, while strabismus itself is an issue with the misalignment of the eyes, even if the acuity is still there. Strabismus affects up to 5% of children, making it the most common visual issue amongst young children. Uneven focus, where a child has just one extremely long-sighted eye, is also fairly common, affecting up to 3% of children. This can be corrected by prescription glasses, and long-sightedness in children is something which can also correct itself over time without any treatment.
Experts estimate that around 25% of children starting back at school this academic year have some form of vision issue, potentially interfering with classroom activities. This is particularly worrying as around 80% of what children learn at school is taken in visually. If their sight is preventing them from understanding and processing information, it can have serious impacts on their day-to-day school life. With the number of short-sighted British children doubling in the last 50 years from 7.2% in the 1960s to 16.4% of children now, the issue of being unable to see the board at school is a growing one.
12 things to look out for in your children:
Misaligned eyes: If you notice that your child’s eyes don’t look in the same direction all the time, it could be a sign of strabismus. If left untreated, it can develop into amblyopia (a lazy eye), and lead to poor visual acuity in the affected eye. Once they reach the age of 9 or 10, any vision loss in the weaker eye is often permanent, so early detection and treatment is vital.
Tilting their head: This can be an indication of eye misalignment, or the beginnings of amblyopia. Tilting their head can help your child to change their angle of vision and focus better with their stronger eye. They might also tilt their head to combat the effects of ptosis, a condition whereby the eyelid droops into their line of sight, impairing their vision.
Covering one eye: Children who cover one eye to help them focus are likely suffering from very poor vision in one eye – so poor that it is easier for them to ignore its signals entirely, rather than to attempt to see using both eyes. Again, this can be a sign of double vision caused by strabismus but, if left to worsen, can develop into a severe lazy eye. It can be treated effectively, however, by putting a patch over the stronger eye to force the weaker one to work harder and therefore become stronger itself.
Rubbing their eyes: If your child rubs their eyes frequently, it might be a sign of eye strain occurring as a result of pushing themselves to focus their vision. This can indicate the need for glasses, although a child rubbing their eyes when they feel tired is also quite normal.
Headaches or eye pain: If your child complains of eye pain or headaches, this too could be down to eye strain or eye fatigue. Constantly trying to increase focus of blurred vision can put a lot of stress on their eyes, so these symptoms are certainly something to watch out for.
Squinting: Squinting their eyes can help a child to focus on an object by changing the shape of their eye and reducing the amount of light entering the eye. It’s a temporary fix to improve their vision when they’re having difficulty focusing on a particular distance. Again, this is a sign that they might need glasses.
Watery eyes: If you notice excessive tearing in your child’s eye, it could be due to a condition called lag ophthalmus. This is when a person’s eyes don’t close completely during sleep, causing them to dry out. You can find out more about dry eyes here, but the tears can occasionally interfere with good vision and cause objects to appear blurry.
Sitting close to the TV: If your child is sitting close to the TV, or holding books or tablets close to their face to read, chances are they could be short-sighted (myopic). They may not know to communicate this with you if this type of vision is what they have always known, or if the deterioration of their sight has been gradual. The longer that myopia is left untreated, the worse it can become, so seeing an eye doctor promptly is important.
Missing lines whilst reading: Astigmatism is a condition where a person’s eyeball isn’t entirely round, and leans more towards being the shape of a rugby ball. The severity of this can vary but, generally, the more rugby-shaped the eye is, the blurrier the vision is. The condition can also distort vision, meaning that children who have an astigmatism might have trouble keeping their place when reading lines on a page. If your child frequently skips lines when reading, an astigmatism could perhaps be the explanation.
General clumsiness: This one is simple; if your child is always bumping into doorways or missing objects which they’re reaching to pick up, it could just be that they’re not seeing things around them properly. Keep an eye on their behaviour and book them in for an eye test if you believe their clumsiness could be vision-related.
Light sensitivity: Heightened sensitivity to light can occur as a result of exotropia, a type of strabismus. This is where one or both eyes turn outwards, and it can often by set off by exposure to bright light. A sign of this may be your child squinting or closing one eye in the sun, which is very normal, but perhaps is more of an issue when combined with strabismic eye movements.
Short attention span: If your child struggles to adapt their visual focus for multiple distances at school, they might find it easier to just mentally switch off from the task at hand. If they need good close-up vision for writing, and good distance vision for reading the whiteboard and screens, it can be a challenge to flick between the two. This sometimes might look like a lack of focus on schoolwork, but there could be more than meets the eye to what seems like behavioural issues.
Children should have a full eye screening around their third birthday to pick up any refractive errors and to be prescribed glasses – either for short- or long sight – if needed. If the tests show that your child has some form of amblyopia, treatment might involve patches or eye drops to strengthen the weaker eye. Most of the 12 signs and symptoms we’ve mentioned above are very common, and the amount of children wearing glasses is growing all the time.
While most vision correction surgeries, such as Laser Eye Surgery, aren’t suitable for people under the age of 18, glasses – and contact lenses for teenagers – are an effective temporary fix. If you’re at all concerned about your child’s eyesight, visit an optician as soon as possible for a full range of eye tests.