Ask the Doc: How Can I Tell if My Child Has a Vision Disorder?

“Approximately 1 out of every 20 preschoolers has a vision problem, but with only about 15 percent of preschool children actually getting the recommended routine eye exam, many vision issues go undiagnosed. Our children are surrounded by visual cues that help them learn everything from their ABC’s to the correct way to safely cross the street, and poor visual health can potentially impact everything from academic progress to social development. By understanding your children’s eye health, you can help them get the running start they deserve.

Common Childhood Vision Problems

The most common problems affecting children’s eyes are:

  • Amblyopia – Often referred to as a “lazy eye,” amblyopia is a condition in which the vision in one eye is less developed than the other. In some cases, the vision might be bad and not correctable even with glasses in BOTH eyes! If this is not treated at a young age, it might be permanent. Amblyopia may be accompanied by strabismus, a visual problem in which the child’s eyes are not straight and point in different directions. This might be correctable with glasses, or might require surgery. The only way to tell is by having your child examined at an early age, especially if there is a family history of strabismus and/or amblyopia.
  • Ptosis  – Ptosis occurs when the child’s upper eyelid droops, often so much so that vision is obscured. This can cause amblyopia and possibly strabismus and needs to be evaluated as early as possible.
  • Hyperopia (Farsightedness)  – Hyperopia is very common in young children and generally resolves with age, but children with significant hyperopia can develop both strabismus and amblyopia. Early evaluation is the only way to determine if the child’s eye needs to be corrected with glasses. Once again, early intervention is essential to protect the child’s vision.
  • Conjunctivitis  – Conjunctivitis is most commonly called “pink eye” because of the red inflammation that results from the underlying cause, which can be anything from a virus to bacteria to environmental irritants or trauma. All conjunctivitis cases are treated differently, and because the child has “pink eye” doesn’t mean they need an eye drop, or are even contagious to others. An examination is necessary to determine if the child needs treatment, or if they need to be separated from others.
  • Convergence Insufficiency – Children who have trouble reading or focusing on nearby objects might have this condition, in which the eyes have difficulty working together to focus on a single image.

Signs and Symptoms of Vision Disorders in Children

In addition to symptoms unique to the vision disorders listed above, parents should also be on the lookout for general signs of vision problems such as:

  • Sitting too close to the television or holding a book too close to the face while reading
  • Sensitivity to light
  • Excessive eye rubbing or tearing, especially when trying to concentrate
  • Closing one eye when trying to focus
  • Difficulty following an object with their eyes
  • Headaches, particularly later in the day
  • Clumsiness and/or frequent stumbling over low-profile hazards like curbs and step
  • Or even no obvious vision problems
    • “My child sees fine” may not be necessarily true. Is there a family history of vision problems? The only way to know if there is a problem with developing vision is to be examined to make sure the eyes are healthy and developing good vision in both eyes. Ask me about my own 4-year-old daughter who was seeing fine and had no vision issues, to being diagnosed with legal blindness in BOTH eyes! This could only be done with a full eye exam.

How You Can Protect Your Child’s Eye Health

One of the best ways to protect your children’s eye health is by scheduling eye exams at the ages and milestones recommended by experts. Illinois law requires comprehensive eye exams for all children entering kindergarten or those enrolling in public, private or parochial school for the first time. The American Academy of Pediatrics (AAP), the American Association for Pediatric Ophthalmology and Strabismus (AAPOS), and the American Academy of Ophthalmology (AAO) agree that children should have their first comprehensive eye exam (in addition to the basic tests performed at birth) when they’re between 6 and 12 months old.

Children should have their first visual acuity test around the age of 3; this is generally the age at which children who are nearsighted or farsighted are first prescribed glasses. Follow-up exams for both visual acuity and eye alignment generally occur around the age of 5. From then on, the AAP, AAPOS and AAO recommend children receive biannual eye exams conducted by an eye specialist in addition to screenings at school, while children already wearing glasses should have their eyes checked once a year.

Have your children had their eyes checked lately? To schedule a comprehensive eye exam at Illinois Eye Center call (309) 243-2400.” – Dr. Steven J Lichtenstein, fellowship-trained specialist in pediatric ophthalmology and strabismus

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