Healthy Living

Vision Problems in Children

Vision Problems in Children

Key Takeaways

  • Common vision conditions that occur in children are crossed or wandering eyes and uneven focus.

A child’s eyesight develops over time, starting with the ability to see objects 8 to 10 inches from their face. The child's eyesight improves gradually between the ages of 12-weeks-old to 16-weeks-old, to which they are able to see objects from farther away. Vision problems in children arise between the ages of 18-months-old and 4-years-old.

The two most common vision problems noted in children include:

  • Crossed or wandering eye – this affects 3% to 5% of children. This condition is characterized by a drifting eye or a crossed look with respect to the other eye. “The actual problem behind this condition is not the eye but a defect in the nerve network in the brain”, says David Epley, MD, a pediatric ophthalmologist in Washington.
  • Uneven focus – One eye is farsighted, while the other isn't, and occurs between 2% to 3% of children. This is very difficult to detect, as children are not aware that their focus is compromised. The compromised vision in the weak eye is called lazy eye or ambylopia. In fact, since they have been seeing that way since the time they remember, they do not complain of any difference. The condition if left untreated for quite some time may result in vision loss in the weaker eye. Loss of vision may be a gradual process but once set, between the ages of 9-years-old and 10-years-old, it remains permanent. This condition should be detected early enough so that it can be reversed.

If ambylopia is diagnosed in a screening test, the common treatment methods include:

  • Eye drops
  • Eye patches
  • Prescription lenses
  • Surgery

Eye patches, eyedrops, and lenses help to treat the most common underlying conditions for ambylopia – misalignment or uneven focus. By using patches, drops, and lenses the vision in the dominant eye is occluded so that the weak eye has to perform harder to get a good vision. This encourages the formation of a better network from the brain to the eye. Prescription lenses correct the uneven focus of the weak eye. If none of these are able to correct the problem, surgery might be recommended.

The treatments continue until the weak eye is better. In the case of eye patches, this may be for one year or so. In some kids, the treatment may take a longer time as the brain forms new connections to the eye. Compliance with the patch is the most important thing to be taken care of in children. As the patch covers their strong eye, it will force them to use the weak eye and they may have poor vision initially.

In many cases, vision problems are silent without any obvious symptoms, and can be detected only through vision screenings. Sometimes there may be symptoms of other conditions, such as infection, cataracts, or other issues.

Some of the most common symptoms include:

  • Rubbing of the eye
  • Increased amount of tear production
  • Swelling
  • Redness
  • Crusting in the eyes
  • Sensitivity to light
  • Bulging eyes
  • Droopy eyelids
  • White, yellow, or gray-white material in the pupil