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Child Vision Problems, Screening, and Treatment

by Brandon on Tue Jan 31, 2012 3:56 am
Everyone has a vision of what children's eye problems look like: Squinting, sitting too close to the television, rubbing their eyes.

Though those can be symptoms of vision issues, sometimes there are no signs your child isn't seeing well. Here's what to watch out for and what to do about it.

Happy to See You: Your Child's Vision In the first few months of life, infants can only see clearly objects that are 8 to 10 inches from their face. It isn't until 12 to 16 weeks that their eyesight begins improving, and they start seeing things more clearly and further away.

Over the next year, kids then develop depth perception, eye-body coordination, eye-hand coordination, and the ability to judge distances. It's rare for children to have vision problems at this age.

Silent Symptoms: Vision Problems in Children Vision problems in kids tend to emerge between 18 months and 4 years old. The two most common vision issues are:

A crossed or wandering eye, which troubles 3% to 5% of children. Symptoms include an eye that drifts or appears crossed in respect to the other eye, though "it isn't really the eye that's the problem," says David Epley, MD, a pediatric ophthalmologist in Washington. "It's the brain's wiring that's at fault." Uneven focus, where one eye is more farsighted than the other, affects 2% to 3% of kids. This vision problem is the hardest to detect, because young children don't know their vision is compromised. "Seeing that way, it's all they've ever known," says Mary Collins, MD, a pediatric ophthalmologist practicing in Maryland, "so they won't say anything about it." Uneven focus or a slightly wandering eye may not seem that alarming, but if either condition goes untreated, a child's stronger eye -- the one that sees further, or focuses better -- slowly becomes their dominant eye. The brain starts ignoring the images coming from the weaker eye, and stops developing the nerve connections leading to it. By the age of 9 or 10, the vision loss in that weaker eye is usually permanent.

The compromised vision in that weaker eye, called amblyopia or lazy eye, doesn't have to happen. It can be stopped and reversed, but it needs to be caught early with a vision screening.

The Eyes Have It: Vision Screening and Treatment Your child's first vision screening will probably be done by the family doctor or pediatrician. The American Optometric Academy recommends that infants get vision screening at 6 months, at 3 years, and every two years after that. The important thing isn't which health care provider performs that first exam, but when. The earlier the better, says Collins, who agrees with the AOA recommendation for a full screening at age 3.

If that initial screening finds a vision problem, the next step is having a more in-depth examination done by an ophthalmologist. If that screening uncovers amblyopia, treatments may include:

Eye patches or eyedrops Prescription lenses Surgery
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