If you are a parent or grandparent, it’s important to be aware of eye issues that can impact children – from infancy to adolescence. Visual functioning is a strong predictor of academic performance in school-age children. Uncorrected vision problems in childhood can impact socialization, coordination, school performance, and sports/recreation activities. The longer a vision condition goes undiagnosed and untreated, the more a child’s brain learns to adjust to it, which may lead to permanent vision loss. Moreover, untreated eye disorders in childhood can impact health and well-being throughout adulthood.
The Role of Genetics
The vast majority of infants are born with healthy eyes, however, certain eye diseases have a genetic component. More than 60% of blindness in infants is linked to inherited eye disease. These include congenital cataracts and glaucoma, retinal degeneration, optic atrophy, and eye malformations. Other eye conditions partially tied to genetics include strabismus (crossed eyes), amblyopia (lazy eye), and refraction errors such as myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. Eye abnormalities can also be caused by other inherited diseases, for example, children with Tay-Sachs disease typically have a cherry-red spot on their eyes. Tay-Sachs symptoms usually develop around 3-6 months of age.
Signs of Eye Problems During Childhood
Occasionally, otherwise healthy babies develop eye and vision problems. If you notice any of the following signs, schedule an appointment with your child’s pediatrician, who can recommend a specialist if needed.
Infancy to Age 2
- Excessive tearing may indicate blocked tear ducts
- Red or encrusted eye lids can be a sign of an eye infection
- Constant eye turning can signal a problem with eye muscle control
- Extreme sensitivity to light may indicate elevated pressure in the eye
- Appearance of a white pupil may indicate the presence of eye cancer
Preschool Children: Ages 3 to 5
According to Prevent Blindness America, more than one in five preschool-age children enrolled in Head Start have a vision disorder. At this age, children typically don’t complain about their eyes. If you notice any of the following signs, schedule an appointment with an eye doctor.
- Tilting the head
- Frequently rubbing eyes
- Short attention span relative to age
- Eye(s) turned in or out
- Sensitivity to light
- Sitting close to the television or holding a book too close
- Difficulty with eye-hand-body coordination when playing ball or riding a tricycle
- Avoiding coloring activities, puzzles, and other detailed activities
School Children: Ages 6 to 18
It is estimated up to 80% of childhood learning is associated with the eyes. Undiagnosed eye problems can lead to headaches, fatigue, and other problems caused by eye strain. Vision can change frequently during school years, so regular eye exams are important. Parents and teachers should look for the following signs, which necessitate a visit to the eye doctor.
- Frequent eye rubbing or blinking
- Short attention span
- Recurrent headaches
- Covering one eye
- Eye(s) turned in or out
- Seeing double
- Tilting the head to one side
- Avoiding reading and other close activities
- Holding reading materials close to face
- Losing place when reading
- Problems recalling what was read
Common Childhood Eye Conditions
Amblyopia (lazy eye): This condition affects 2% of children ages 6 months to 72 months and is the most common cause of vision loss in youngsters. Generally, vision loss impacts only one eye, but children with amblyopia are nearly three times more likely to develop vision impairment in their stronger eye as adults. Early detection of amblyopia and patching of the stronger eye prior to age 7 is most effective. If left untreated or treated too late, amblyopia can lead to permanent vision loss in one or both eyes.
Strabismus (crossed eyes): This condition affects 2-4% of children ages 6 and younger. It is often referred to as crossed eyes, but technically is misalignment of the eyes. When the eyes are oriented in different directions, the brain receives conflicting visual input. This interferes with binocular vision development, depth perception, and can lead to amblyopia. The physical appearance of crossed eyes negatively impact a child emotionally and socially and can take a toll on their self-esteem.
Myopia (nearsightedness): This refractive error affects 4% of children ages 6 months to 72 months and 9% of children ages 5 to 17. According to research, the prevalence of myopia is rising at an alarming rate.
Hyperopia (farsightedness): This refractive error is far more common in children than myopia. It impacts 21% of children ages 6 months to 72 months and 13% of children ages 5 to 17.
Astigmatism: This irregularity in the shape of the cornea or lens causes blurry vision at all distances if left uncorrected. An estimated 15-28% of children ages 5 to 17 years have astigmatism, depending on the diagnostic threshold used. Children with myopia or hyperopia are more likely to have astigmatism. Prescription eyeglasses can correct all refractive errors, as long as they are detected early.
Childhood Eye Injuries
An estimated 60,255 children age 18 and younger were treated at U.S. hospital emergency rooms in 2016 for eye injuries. Most incidents in younger children involved corneal abrasions due to poking the eye with objects like pens, pencils, crayons, paper clips, scissors, or coat hangers, and getting foreign matter in the eye, (e.g. arts and crafts supplies). Teens tend to suffer injuries related to sports and fireworks, while home workshop activities using sanding and grinding equipment are more common in boys.
Prevention is Key to Children’s Eye Health
The U.S. Preventive Services Task Force recommends vision screenings in children ages 3 to 5, at least once. National pediatric preventive care guidelines recommend annual vision screenings by pediatricians at ages 3 to 6, and then at regular intervals through late adolescence. If you notice any of the aforementioned signs in your children or grandchildren, schedule an eye doctor appointment as soon as possible.
More than 90% of all eye injuries can be prevented through the use of appropriate protective eyewear. Children should wear polycarbonate eye protectors made specifically for baseball, basketball, football, racquet sports, soccer, hockey, lacrosse, and paintball. Proper eyewear should also be worn for home workshop activities. Chemicals and other potentially dangerous household objects should be stored in places inaccessible to young children. Parents and grandparents need to supervise younger children, buy age-suitable toys, and put them away after use to avoid accidents.