How can I recognise a vision problem in my child?

As Nathalie Voide, a doctor in the paediatric strabology and ophthalmology unit at the Jules-Gonin Ophthalmic Hospital, explains detecting a visual disorder in children is not easy, unless the child is born with profound visual impairment. For example, a child who does not see well with one eye will probably never complain and will adapt to this situation. Parents, the family or school environment, professionals, paediatricians, orthoptists and ophthalmologists, all have a role to play in detecting these visual problems.

What are signs of visual impairment in children? 

Here are the main signs parents should be aware of that may require an ophthalmological examination:

• Poor coordination and misaligned eyes are usually signs of strabismus.
• A jerky, spontaneous, involuntary movement of the eyes, a kind of rhythmic, rapid oscillation. The eyes do not focus properly: they move on their own, a little like windscreen wipers. This is called nystagmus.
• A drooping eyelid can cover one eye and prevent the vision of this eye from developing.
• In photos, an asymmetry of pupillary glow with one orange pupil and the other whitish shows that there is probably something obstructing the child’s vision.
• Tears, eye redness. 
• At the age when children start to talk, they may complain of headaches, blurred vision, adopt an abnormal head position or complain of discomfort with light. 

How can I detect an eyesight disorder in a child? 

Here’s a simple test we can all carry out at home: cover one of your child’s eyes, then the other, and see if the reaction is similar between the two eyes. If the child reacts to monocular occlusion, this probably means that he sees less well in one eye than the other and that further investigations will be necessary.

What are the most common visual problems in children? 

There are various visual problems, the most common in children are: 

Myopia: short-sighted children’s distance vision is affected, so they squint when they look into the distance. This will also cause blurred far-vision, which cannot be overcome with visual effort. However, the child’s vision is clear at close range.

Astigmatism: Astigmatism causes blurred and distorted vision at all distances. These visual disorders can also cause confusion of letters or numbers. An astigmatic child may complain of headaches and is sometimes bothered by light. 

Hypermetropia: near-vision is affected. A far-sighted child has a refractive visual disorder that occurs when the eye is too short, or their cornea and lens are too flat. The child then has difficulty distinguishing objects close to him and suffers from headaches.

What are the solutions to correct visual impairment in children? 

• An eye examination carried out by the ophthalmologist will make it possible to detect if the child has vision problems. 
• Once the disorders have been screened by the eye specialist, it will be possible to correct them by wearing glasses and corrective lenses adapted to the visual defect. 
• Rehabilitation of the eyes can also help the child. The orthoptist carries out an assessment to evaluate the visual abilities and the disorders to be treated. Rehabilitation sessions allow the child to reduce eye fatigue. But also to have better visual acuity and correct disorders.

If in doubt, it is best to see your paediatrician or have a check-up with an ophthalmologist. It is always best to detect problems early for simpler treatment.