11 Signs That Show Your Child Needs Glasses

Vision problems in childhood are not always obvious. The signs are not as clear as in adults, so you won't hear a small child talk about "blurred vision".

Vision problems are common in school-age children and the treatment can be as simple as a pair of prescription glasses. But if vision problems stay undiagnosed or untreated, they can have lasting effects on eye health, on schoolwork and on a child's confidence in normal activities.

These often very mild symptoms may point to a vision problem in children:

1. They tend to close one eye during activities such as reading or watching TV.
2. They avoid activities that need near vision (reading, homework, using a computer) or distance vision (sports and other leisure activities).
3. Their school grades are lower than normal.
4. They say their eyes feel tired or they have a headache.
5. They rub their eyes a lot.
6. They seem sensitive to light.
7. Their eyes water for no obvious reason.
8. They hold books unusually close to their face.
9. They use a finger to guide their eyes along the page, otherwise they lose their place in the text as they read.
10. They sit very close to the television or computer screens.
11. They squint or tilt their head to see better.

If your child shows any of these signs, an ophthalmologist can help you find out whether an eye problem is the cause.

Childhood refractive errors

Refractive errors are the most common causes of vision problems among school-age children. When children have a refractive problem, it is usually one of the following:

• Myopia (short-sightedness)
• Hyperopia (long-sightedness)
• • Astigmatism

In some cases, a child may have astigmatism together with myopia or hyperopia at the same time.

These refractive errors can usually be corrected with a pair of prescription glasses or contact lenses. You receive an eye prescription after your child's eye examination and you can use it to buy glasses wherever you like.

Myopia is a growing problem in children. It is natural for myopia to increase a little during childhood and adolescence, but sometimes it progresses very quickly. This is known as progressive myopia and can lead to a condition called high myopia.

This high level of myopia significantly increases the risk of sight-threatening diseases such as retinal detachment, macular degeneration, cataract and glaucoma later in life. Fortunately, there are now ways to reduce these risks by slowing the progression of myopia.

Other childhood eye problems

Refractive errors change how light is registered inside the eye, but other childhood eye conditions can affect how the eyes move together.

Between 5% and 10% of school-age children are thought to have a problem coordinating or focusing the two eyes.

These eye-coordination problems are:

• Strabismus - a problem with how the eyes align. Strabismus is often called "crossed eyes", although that describes only one type: esotropia.
• Amblyopia - also called "lazy eye". Reduced vision in one eye makes the affected eye "wander" away from the centre of vision.
• Convergence insufficiency - a form of intermittent exotropia, itself a type of strabismus. The eyes struggle to work together to focus on near objects; when the child tries to focus on something close, one eye turns slightly outward instead of inward.

Refractive errors and eye-coordination or focusing problems are not the only conditions that can affect a child's life. Other common problems include:

• Colour vision deficiency: more precisely known as colour vision deficiency, it causes problems seeing certain - but rarely all - colours. There are several types.
• Vision loss: the most common causes include injuries, congenital conditions and complications from other health problems. About 3% of children under 18 are either visually impaired or blind.

Vision, attention (ADHD) and learning difficulties

Between 5% and 15% of school-age children are affected by a learning difficulty. About 80% of these are reading disorders such as dyslexia. Nearly 1 in 10 school-age children has attention deficit hyperactivity disorder (ADHD).

These conditions are not the same as vision disorders, but they can coexist with certain eye problems. Convergence insufficiency is one of the disorders known to cause attention problems. It is very easy to confuse with ADHD, and is three times more common in people with ADHD than in those without.

Beyond visual symptoms such as blurred or double vision, convergence insufficiency can cause attention problems that include:

• Difficulty staying focused
• Difficulty keeping their place while reading
• Reading slowly

Fortunately, treatment for convergence insufficiency is usually very effective and can help a child regain their attention.

How often do children need a vision screening or eye exam?

Vision screening is the simplest way to monitor children's eye health as they grow. Although it does not replace a full eye examination, screening can be used to spot the signs of eye problems with less time and cost.

Experts recommend the following vision-screening schedule for children:

• As a newborn
• Between 6 and 12 months
• Between 1 and 3 years
• Between 3 and 5 years
• After the age of 5

As children move through school age, an eye examination every year is recommended, whether or not there is a vision problem. If the person carrying out a vision screening suspects a problem with your child's eyes or vision, such as a refractive error or an eye-coordination condition, they will refer your child to an ophthalmologist for a full paediatric eye examination.

If you prefer to see a doctor who specialises in diagnosing and treating children's eye conditions, look for a paediatric ophthalmologist. These doctors are specially trained in the diagnosis, management and treatment of children's eye problems.