Child Vision

Does Our Child See Well?

When they are young, children cannot assess for themselves whether they see well or not.

What are the first signs that should raise questions about our child's vision?

• deviation of one or both eyes;
• presence of white pupil;
• eye redness, eye pain;
• holding toys too close to the eyes;
• frequent blinking, squinting;
• tearing, light sensitivity.

Regardless of the child's age, in the presence of these signs, the child should be brought for an ophthalmologic examination (even from a few months of age). Even if they don't notice anything abnormal in their child, parents should bring children for the first checkup between 6 months and 1 year, then at 3 years and before going to school, at age 5. This should be done because there are situations when both eyes look normal, but one of them is weaker, and the child practically sees with only one eye, without realizing it.

What Are the Most Common Conditions That Affect Children's Vision?

First of all, we speak about refractive errors such as myopia (the child sees well up close but doesn't see at distance); hyperopia (when they don't see well either up close or at distance), astigmatism (the child doesn't see images correctly). In all these situations, vision correction is done by wearing glasses.

Amblyopia (lazy eye) usually develops when one eye sees well, while the other sees poorly, either due to a high diopter (from myopia, hyperopia or astigmatism), or due to an obstacle in the visual axis (e.g.: congenital cataract). As treatment, in the first situation wearing appropriate glasses is recommended, in the second situation surgical removal of the obstacle is recommended as soon as possible.

In both situations, amblyopia therapy exercises must be done afterwards (covering the good eye and "putting the lazy eye to work"). The rhythm and period of covering (occlusion) depend on how profound the vision decrease is and the child's age. The earlier amblyopia is discovered and the visual stimulation process of the weak eye begins, in an attempt to recover vision, the better the results.

Strabismus represents deviation of one or both eyes toward the nose (convergent strabismus) or outward (divergent strabismus). Beyond the aesthetic inconvenience, the presence of strabismus prevents normal vision development. In this situation, either the child sees better with one eye (the one in normal position) than with the other (deviated), or has alternating vision (sees alternately with both eyes, which alternately have deviated position). Strabismus correction is done in the first stage by permanent wearing of glasses (if there is a refractive error), also using prismatic lenses, accompanied or not by covering (occlusion) of the better-seeing eye, in situations when there is also amblyopia. If following these attempts, the eyes don't improve their position, surgical intervention is used. There are situations when surgery is recommended from the start (in forms of congenital strabismus with large angle, which begin before 6 months).

Why Is It Good to Bring the Child to the Ophthalmologist as Early as Possible?

Because we all want normal vision for our child.

Normal, binocular vision implies good, equal visual acuity of both eyes, alignment of their axes, coordinated movement of them. Affecting any of these elements has long-term repercussions on vision. We speak of normal vision when the image of an object is perceived simultaneously by both eyes as a single, three-dimensional image; it also implies correct appreciation of distances and moving objects.

Binocular vision forms in the first years of life (up to 5-7 years) and that is why it is very important to pay maximum attention to the development of our child's vision during this period. The earlier vision defects are detected, the easier they can be corrected, with beneficial effects on subsequent vision evolution.

Measuring diopters in children can be done even under 1 year of age, with a special device called Plusoptix, and, when necessary, children can wear glasses even from this age, having a surprisingly good adaptation capacity.

In case of amblyopia presence, wearing appropriate glasses accompanied by occlusion to try to recover vision in the lazy eye is also very important to be done early. The goal is for both eyes to achieve equal vision as soon as possible, thus allowing the development of binocular vision. After age 7, correcting vision defects becomes increasingly difficult and is almost impossible to achieve after 9-10 years.

In conclusion, it is important to bring the child to the ophthalmologist immediately upon noticing any of the above signs, and if nothing is noticed, preventively, ophthalmologic screening is indicated starting from 6 months of age, followed by checkup at 1 year, then at 3 years and before going to school, at age 5.