Is your child squinting? Blinking rapidly? Struggling with reading? It could be a sign your little one has an eye problem.
While children often let their parents or caregivers know when something is bothering them, they themselves may not realize when there is a concern with their eyes or vision. That is why it is important to be familiar with some of the more common ocular and vision problems that can affect children.
August is Children’s Eye Health and Safety Month, and it marks a good opportunity to learn more about six prevalent pediatric eye health problems.
Symptoms of Eye Problems
Children may not articulate if they are having trouble with their vision, but there can be signs to suggest it. Health assessments performed by the pediatrician are critical to ensure healthy visual growth and development as well as to monitor reaching vision milestones.
Children begin to develop their vision from the moment they are born. By the time they are 6 months old, they should be able to follow or track an object as well as maintain good ocular alignment.
As children get a little older, parents should look out for excessive blinking; excessive tearing; excessive eye rubbing; leaning or tilting the head to see an object, getting too close to a TV or book; and holding toys or other objects close to the face. Older children may have headaches, difficulty concentrating and trouble seeing the board at school.
Behavioral and learning problems can mask vision problems. Children who have a difficult time with school work, whether it be challenges with reading and writing or with attention and concentration, may actually have an underlying vision problem. It is possible that if the root cause of the condition is identified and treated, children may fare better as their attention and behavior improve.
If you notice any red flags, reach out to your child’s pediatrician or a pediatric ophthalmologist.
Common Eye Problems
1. Refractive errors. Refractive errors occur when the structures of the eye that bend and focus light do not work properly. The three types of refractive errors are: nearsightedness (myopia); farsightedness (hyperopia); and astigmatism.
Individuals who are nearsighted have difficulty seeing objects that are far away. The eye has a hard time focusing the image on the retina, which is the receptive layer of the eye.
Those who are farsighted have greater difficulty seeing objects at closer distances. In this case, light entering the eye is focused behind the retina instead of directly on it.
Astigmatism is an abnormal curvature of the cornea, causing light to improperly focus on the retina. Children with this problem often have blurry vision.
All three refractive errors can be corrected with glasses — although in many cases, children who are farsighted may not need corrective lenses unless the problem worsens. Children often adapt to farsightedness on their own!
2. Strabismus. Strabismus is a condition in which the eyes do not align. Many young children do not have symptoms of this condition, but some may squint or turn their head when looking at an object. In certain situations, parents may even notice the eyes are not looking in the same direction. Children with this condition should be evaluated by a pediatric ophthalmologist, who may recommend therapies such as glasses, temporary eye patching, or surgery. Without proper treatment, strabismus could negatively affect vision development.
3. Amblyopia. Amblyopia is a condition in which the brain has difficulty interpreting images seen by the eyes. Amblyopia can affect one or both eyes simultaneously. Again, children may not have any symptoms, but parents may notice the child squinting or tilting their head to look at an object. Standard treatment includes glasses and eye patches: The patch covers the strong or dominant eye, allowing the brain to rehabilitate the weaker eye.
It is recommended that children with strabismus and/or amblyopia be evaluated and start treatment as early as possible. Following birth, a child’s brain is constantly growing and developing, effectively learning how to see the world. Vision generally matures by 8 to 10 years of age. Eye and vision conditions that occur and remain unresolved during that time period could lead to permanent and lifelong vision deficiencies.
4. Digital eye strain. Digital eye strain is a condition that can affect children — and adults — who spend too much time in front of screens, such as televisions, phones, tablets, and computers. This has become a growing issue in recent years, and especially during the COVID-19 pandemic as many children used computers for remote learning and education. Symptoms may include excessive blinking, dry eyes, blurred vision, eye redness, and headaches. Parents are encouraged to teach their children the 20-20-20 rule: For every 20 minutes, take a 20-second break from a screen or a book and instead look at something at least 20 feet away.
Recently, filters that block blue light have been suggested to have protective and beneficial effects. Unfortunately, the research on their efficacy is limited. Many electronic devices do have built-in blue light blocking technology that can be activated.
5. Chalazia and styes. Chalazia and styes are “lumps and bumps” in the eyelid stemming from an infection (stye) or from a plugged or blocked oil gland (chalazion). Children may develop redness and/or swelling around the eyes, and eyelids may become tender and painful. These typically do not affect vision but can be quite uncomfortable. Frequent and consistent application of warm compresses can help. Most of these lesions clear within about a week, though some may take months to get better.
6. Absent Red Reflex. Often seen on a picture, a red reflex refers to the red color in the eye’s pupil that is created by the reflection of outside light from the retina. Photographers may call this “red eye.” The absence of the red reflex may be a sign of strabismus, refractive error, cataracts, tumor or other serious eye problem.
If you are concerned about your child’s eye health, reach out to the pediatrician or a pediatric ophthalmologist. At Kaiser Permanente, we encourage parents to send us photographs of their children’s eyes through secure message. We can often detect an eye problem from a picture alone.
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