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. All such irregularities can easily be picked up in the eye test, which also checks for colour vision deficiencies.

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 (shortsightedness), hyperopia (longsightedness), 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

Infancy to Age 2

Occasionally, otherwise healthy babies develop eyes and vision problems. If you notice any of the following signs, schedule an eye appointment.

- 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
- 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

More than one in five preschool-age children enrolled in preschool 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.

- Squinting
- 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 colouring 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 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 a 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 (shortsightedness)
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 (longsightedness)
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.

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.