Can Your Child See Ok? How to Tell If Something’s Amiss

Healthy Living

August 18, 2019

Vision is an integral part of a child’s life. Even before they start school, children learn how to play and interact with the world based on what they can or can’t see. Once kids start school, vision problems in sighted children can seriously delay academic progress if not caught and addressed early. This is why it’s so important to make yearly eye exams a part of your child’s healthcare routine. If you keep an eye out for the following warning signs, you’ll have a greater chance of catching and treating vision problems early.

Babies 3 Months and Older

At three months old, babies should be able to follow a toy steadily with their eyes, a skill known as tracking. Infants who can’t keep their eyes on an object or who appear unable to see should be given an eye exam right away. At this age, babies have no way of expressing, or even knowing, that something is wrong with their vision. Everything is brand new to them. If things look blurry or distorted, they would assume that’s how the world looks. If your baby can’t or doesn’t seem to track like he should, talk to your pediatrician.

Another condition that can occur during the first couple years of life is the development of a retinoblastoma. This is a malignant tumor that begins to grow within the retina itself. Although this type of eye cancer can happen to people of any age, it’s most common in children two years old and younger. 

An easy-to-notice early sign of a retinoblastoma is a cloudy white pupil that can look silvery or yellow under bright light. Other symptoms include crossed eyes, an enlarged pupil, poor vision or even a cloudy iris (the colored part of the eye). If you notice any of these signs, find an ophthalmologist who specializes in pediatric eyecare. Your pediatrician can probably make suggestions.

Toddlers & Preschoolers

As kids get older, they rely on their vision more to play with their toys and gain foundational knowledge that they’ll need as they get older, such as their colors, shapes, letters and numbers. Acute vision at this age is what allows for the development of proper hand-eye-body coordination, fine motor skills and the perceptual abilities they need to begin learning how to read and write.

Vision problem warning signs become more apparent at this age. Children themselves begin noticing that things aren’t as clear as they should be and may try to do things to help them see better. Around three to four is when you may begin to notice some of the warning signs of vision issues, including: 

  • Squinting and eye rubbing when trying to do something that requires sight
  • Sitting too close to a screen when watching or interacting with it
  • Lack of interest in detail-oriented activities, like coloring or building puzzles
  • A short attention span (even for their age)
  • Trouble with body movement coordination, such as playing with a ball or riding a bicycle

If you notice any of these signs, mention them to your child’s pediatrician. Vision problems in young children can be treated and possibly even corrected if caught early enough.

Even if you don’t see any of these behaviors in your child, it’s still important to have them tested by your family doctor or an optometrist every year. Your pediatrician will likely check your child’s vision through the age of three, after which you might start taking her to see an optometrist or ophthalmologist depending on any issues she’s having.

Some children won’t show any signs of having difficulty seeing at all, depending on the type and level of visual impairment. This is especially common when their eyes are suffering from uneven focus, a condition in which one eye is more farsighted than the other. Children with uneven focus often don’t realize that anything is wrong with their vision since one eye compensates for the problems of the other.

Another asymptomatic vision problem that can develop during this time is amblyopia, also known as a wandering or lazy eye. This happens when one of the eyes can’t see as well as the other and so the brain begins to ignore the signals coming from the weaker eye. This causes that eye to relax even more, weakening it even further. 

Both uneven focus and amblyopia can eventually lead to partial or complete loss of vision in the weaker eye, but both can also be corrected through early intervention.

School-Aged Children

Academic success doesn’t hinge on being able to see, but correctible vision problems should be addressed to avoid unnecessary setbacks. As kids get older, the demand on their visual abilities only increases. The print in books gets smaller and they spend much more time reading and writing. If they’re unable to see well and the issue isn’t treated, their educational progress is going to suffer.

Some of the warning signs for vision problems at this age are the same for younger children. If you see them squinting frequently, tilting their head to see better or rubbing their eyes excessively, bring it up with your pediatrician. Other symptoms include:

  • Holding a book too close to their face when reading
  • Easily losing their place when reading or having to use a finger as a guide
  • Closing one eye to see better when reading or watching TV
  • Frequent headaches or eye discomfort
  • Avoiding activities that demand sharper vision, such as homework, reading, playing sports, using computers and seeing things at a distance
  • Sensitivity to light and excess tearing
  • A sudden drop in grades and academic performance

Left untreated, visual impairment could impact your child’s perception of school. If using their vision is tiring and uncomfortable, children will be less likely to want to read and study. They may end up getting incorrectly diagnosed with a learning disorder when all they might need is a pair of glasses. While this isn’t always the case, it could be a contributing factor. 

What Causes Vision Issues?

Vision issues can have many different causes. Refractive errors, such as farsightedness, nearsightedness and astigmatism, are often inherited and can be diagnosed during early childhood or may become more pronounced during later childhood as the body grows and the shape of the eye changes. 

Some retinoblastomas are also genetic and some babies may even be born with this condition. Other conditions, such as a wandering eye, are often caused by a mild visual impairment that was left untreated. If farsightedness isn’t corrected, it can develop into uneven focus, which in turn can develop into a lazy eye. If still left untreated, lazy eye can result in blindness.

We still don’t know why some other conditions develop, though. Certain types of retinoblastomas, for example, are caused by random mutations later in childhood that are still not understood. The cause of convergence insufficiency, a misalignment of the eyes, is still unknown as well. Damage to the eye due to sports accidents or rough play can also lead to vision impairment.

Make Eye Exams A Priority

Even if all the causes of vision problems in children aren’t fully understood, what we do know is that comprehensive eye exams are the best way of catching and correcting problems early, ensuring that mild issues don’t develop into life-long problems for our little ones. Don’t think that the eye screenings done by schools and pediatricians are enough. These checkups are fine as a starting point, but they’re usually only superficial and can’t be used to diagnose a serious problem. It’s best to get in the habit of having yearly comprehensive eye exams done by pediatric ophthalmologists for children three and older.