Falling behind at school, a reluctance to look at books or pictures, or a family history of visual impairments are all indications that your child may be struggling to see clearly. Left untreated, some visual impairments can become irreversible. However, the good news is that, if detected early enough, many eyesight ailments in childhood can be corrected with glasses. Here’s how to tell if your child may benefit from wearing glasses.
Common Vision Problems in Kids
There are many different eyesight conditions that may affect your child’s ability to see properly. However, one of the most common pediatric vision impairments is amblyopia, also commonly referred to as lazy eye. Amblyopia is a neural-developmental vision condition, which means that one eye (occasionally both) doesn’t have a strong link to the brain. This results in one eye being weaker than the other. If left untreated, amblyopia can become a permanent vision impairment. “The one that we really worry about the most is amblyopia,” says Heather Cimino, MD, OD, an optometrist specializing in general pediatric optometry at both Cleveland Clinic, Ohio, and at Vision First, a program dedicated to detecting eye diseases in young children in the Cleveland area. “So if one eye from birth, or from really early childhood, is seeing so much better than another eye, the brain will slowly start to ignore the eye that isn’t seeing as well.” Other common visual impairments include refractive errors such as hyperopia, more commonly known as far-sightedness, and myopia, often referred to as near-sightedness. Hyperopia causes close up objects to appear blurry or out of focus, while myopia causes sufferers to find distant objects hard to see. Although myopia often runs in families, myopia rates among children are steadily rising, with experts speculating that this could be linked to a general increase in time children are spending focusing on screens. “In my practice I’ve seen an increase in kids that need glasses because they’re getting more near-sighted because of all the near work [they’re doing], and also just eyestrain from all the virtual learning they’re doing now,” explains Luxme Hariharan, MD, MPH, a pediatric ophthalmologist at Nicklaus Children’s hospital in Miami, Florida, and board-certified ophthalmologist. Strabismus is another common vision problem among children and is categorized as the misalignment of the eyes, resulting in the eyes not always pointing in the same direction. This can be due to severe hyperopia, amblyopia, or certain health conditions. While strabismus symptoms are relatively easy to identify, not all eye conditions are as easy to spot so it’s important to know what the tell-tale signs of vision problems in children are.
Signs Your Child Might Need Glasses
Children may find it hard to tell their parents that they’re struggling with their eyesight for a variety of reasons. For example, they may be too young, or they may think that their limited vision is normal. Thankfully, there are certain signs that parents can look out for instead.
Falling Behind At School
Any issue with a child’s eyesight can have a big impact on their academic progression. “If a kid starts acting up in school, or they start behaving poorly, or doing poorly in school [it could be] because they can’t see what’s going on around them,” explains Dr. Hariharan. “I’ve seen these kids totally turn things around in terms of their behavior and progress…just by getting them in glasses.” An inability to concentrate and reluctance to focus on near-tasks such as reading and writing could be a sign that a child is suffering from convergence insufficiency, a condition that affects the ability to focus on close up objects.
Family History
Often, whether or not your child will require glasses comes down to genetics. Conditions such as myopia, hyperopia, and amblyopia are all hereditary, which means that they run in families. “Certainly if there’s a family history, if both parents wore glasses as children, or even one parent, the odds are going to be pretty good that there could be [an eyesight issue], so it’s worth looking at. Near-sightedness can be very common if both parents are near-sighted," says Dr. Cimino.
Eyes Aren’t Tracking Together
In infancy, it’s common for eyes to wander or cross. However, after approximately 6 months old, eyes not working in alignment could be a sign of amblyopia or strabismus. You may notice that this misalignment becomes more pronounced when your child gets tired. However, amblyopia could still be present even if your child’s eyes appear to be working well together, so it’s important to get their vision screened regularly. “Oftentimes, [the eyes] look aligned,” explains Cimino. “The child seems like they’re doing well. They are learning their letters, they’re doing their work because the stronger eye is picking up the slack.”
Sitting Unusually Close to an Object
If your child has a habit of holding a book an inch from their nose, it could be that they are suffering from myopia, which means that they find it hard to focus on far away objects. “If they do walk up to the television and stand very close, and resist being pulled back, that could be an indicator [of a problem],” says Dr. Cimino.
Reluctant to Focus on Near-Tasks
A child who is reluctant to read books, look at pictures, or focus on other near-tasks could be displaying symptoms of hyperopia or convergence insufficiency, which both cause near-objects to appear blurry. “If a parent notices a consistent resistance to near tasks, it could also be an indication of something going on,” says Dr. Cimino.
Squinting
You might have noticed your child wrinkling up their nose and squinting when attempting to focus on an object. Squinting temporarily changes the shape of the eye, which indicates that it could be a coping mechanism for refractive errors such as myopia and hyperopia. “If a kid is squinting to see things, holding things close to them, blinking, rubbing their eyes, or their eyes are turning in or out, those are tell-tale signs that there might be some kind of vision issue,” says Dr. Hariharan.
Frequent Headaches
Whether it’s for school, entertainment, or talking to friends online, too much time concentrating on screens can result in asthenopia, more commonly known as eye strain. Eye strain can leave children’s eyes feeling dry or tired, and can lead to frequent headaches. “Technology is causing children to focus on [close up tasks] a lot,” explains Dr. Hariharan. “We’re not meant to be focused on [close up tasks] for hours at a time, so that can cause eye strain and headache.” As eye strain typically goes away once you give your eyes a rest, Dr. Luxe recommends taking a screen break every 20 minutes, focusing on something 20 feet away, and blinking 20 times. However, frequent headaches are also a common symptom of hyperopia (far-sightedness), myopia (near-sightedness) and convergence insufficiency, so it’s important to follow up any complaints of frequent headaches with an eye examination.
How to Get Your Child’s Eyes Tested
Approximately 6.8 percent of children in America have a diagnosed eyesight ailment, many of which can be corrected through treatment. However, without intervention, visual impairments can lead to permanent vision loss. “I’ve seen a child go from 20/400 vision to 20/20, just from an eye patch,” says Dr. Hariharan. “But the key is to catch it early.” Your child will have received their first eye examination at birth, with a pediatrician or other trained health professional assessing their eyes for early indicators of health. The American Academy of Ophthalmology (AAO) recommends a follow up check-up between the ages of 6-12 months, again between 12 months and 3 years, and again between the age of 3 and 5. These screenings can be carried out by a pediatrician or family physician, but a child will likely be referred on to an ophthalmologist if a more comprehensive examination is required. Once your child reaches the age of 3, they are able to receive their first comprehensive eye examination with either a pediatric ophthalmologist or pediatric optician. An eye examination is a more in depth look at your child’s overall eye health. “We always recommend that prior to starting kindergarten, every child has a full eye exam, just because of the fact that sometimes there are no signs or symptoms, and there are still vision problems,” advises Dr. Cimino. While every provider is different in the techniques that they use, your child’s first comprehensive eye examination will likely be used to gather information regarding any eyesight diseases or conditions that may run in the family. If your child is able to read, they will be asked to read out letters they can see clearer than others. For younger children, they will be asked to point to pictures instead. A pediatric ophthalmologist or a pediatric optometrist will be trained in special ways to assess your child’s vision through play, says Dr. Hariharan. “We’ll also work with binocular vision, checking the eye muscle, making sure that the eyes are working together, making sure that they have stereopsis or depth perception,” explains Dr. Cimino. As males are more likely than females to suffer from color blindness, they might also be checked for red and green color deficiency. Depending on the findings of the examination, you may be asked to bring your child back within 6 months to a year. Once your child starts school, the American Optometrist Association (AAO) recommends screening once every other year. This is usually done through a school-based vision programs. However, don’t hesitate to seek out a more thorough examination with an ophthalmologist or optician if you feel your child is exhibiting signs of a vision impairment. “The earlier we can see these little ones the better, because they’re going to be using their eyes for their entire life,” concludes Dr. Cimino.
A Word From Verywell
Your child’s eyesight is precious. You can help protect them against any permanent vision loss by getting their vision screened regularly in accordance with either the American Academy of Ophthalmology (AAO) or the American Optometrist Association (AOA). This screening can be carried out either by a pediatrician or family physician. However, for a more thorough examination, you may opt to have your child’s eyes assessed by either a pediatric ophthalmologist or optician.
