Eye health resource
Common Childhood Vision Problems
Common childhood vision concerns include refractive errors such as myopia and astigmatism, amblyopia, strabismus, and eye-health problems such as conjunctivitis. Learn what these terms mean and when an exam is useful.
Reviewed for accuracy by Justin Bazan, OD on .
Children can have vision problems even when their eyes look normal and they do not complain. Some of the most important childhood concerns involve refractive error, visual development, eye alignment, or common eye-health conditions.
Refractive Errors: Myopia, Hyperopia, and Astigmatism
A refractive error means the eye does not focus light on the retina in the way needed for clear vision.
- Myopia (nearsightedness) makes distant objects blurry.
- Hyperopia (farsightedness) can make focusing more difficult, especially when the amount is significant or differs between the eyes.
- Astigmatism occurs when the eye's optical surfaces produce different focusing power in different directions.
Children may squint, move closer to see, report blur, or have no obvious symptoms at all. Glasses are often the simplest correction. Contact lenses can also be appropriate for selected children and prescriptions.
Amblyopia
Amblyopia, sometimes called “lazy eye,” is reduced vision caused by abnormal visual development during childhood. It often affects one eye but can affect both.
Amblyopia can develop when the eyes have very different prescriptions, when one eye is misaligned, or when something such as a cataract blocks clear visual input. The problem is not that the eye becomes physically “lazy”; the brain does not develop normal use of the image from that eye.
Treatment depends on the cause and may include the correct glasses, treatment of an underlying eye problem, and patching or atropine of the better-seeing eye when appropriate.
Strabismus
Strabismus means the eyes are not aligned in the same direction. One eye may turn inward, outward, upward, or downward. The misalignment can be constant or intermittent.
Some forms improve significantly with the correct glasses. Other cases need additional treatment or referral to a specialist. Strabismus can be associated with amblyopia, but the two conditions are not the same.
Progressive Myopia
Myopia often begins in childhood and can progress as the eye grows. Correcting blur is important, but families may also want to discuss strategies intended to slow progression.
Park Slope Eye offers myopia management that may include Ortho-K, low-dose atropine, and appropriate soft multifocal or myopia-control contact lenses. No treatment can guarantee that progression will stop completely.
Conjunctivitis and Other Red-Eye Problems
“Pink eye” describes inflammation of the conjunctiva, but not every red eye is an infection.
Viral conjunctivitis can be contagious. Bacterial conjunctivitis can also spread and may require antibiotic treatment in selected cases. Allergic conjunctivitis is not contagious and is usually dominated by itching, watering, and exposure-related symptoms.
Dry eye, eyelid inflammation, contact-lens irritation, corneal disease, and other conditions can also cause redness. The cause determines treatment and whether school or daycare restrictions are appropriate.
When Should a Child Be Examined?
For low-risk children without symptoms, current American Optometric Association guidance recommends a comprehensive assessment between 6 and 12 months, at least one exam between ages 3 and 5, and an exam before first grade with annual exams thereafter.
Park Slope Eye participates in InfantSEE, and qualifying InfantSEE assessments are available at no charge during the first year of life.
Do not wait for the routine schedule when a child has a persistent eye turn, failed screening, sudden vision change, significant eye pain, white pupil reflex, unusual eye movement, injury, or another concerning finding.
Pediatric Eye Care at Park Slope Eye
Park Slope Eye provides children's eye exams, eyewear and contact-lens care when appropriate, myopia management, and medical eye evaluation within our current scope.
If you have a concern about your child's vision or eye health, book an appointment online.
Originally published . Substantially updated .