Eye Testing in Children

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What are some common eye problems in children?

  • One of the commonest eye problems in children is amblyopia (also known as lazy eye) this happens in up to 5% of children.
  • Amblyopia can be caused by a squint (crossed eye) in which case the squint will generally be visible, but it can also be caused by problems which are invisible to family members.
  • Other problems include conjunctivitis, blocked tear ducts, droopy eyelids, eyelid cysts and allergies

Do eye problems run in families?

  • Some eye problems like squint (crossed eyes), amblyopia (lazy eye) long sight and short sight do commonly run in families.
  • If a parent, sibling or cousin has one of these a child should have an eye test at about 3 years old with an experienced eye doctor.
  • If there is a rarer genetic disease such as retinoblastoma or congenital cataract in the family then children should be examined as babies by an eye doctor.

Why are eye tests important for children?

  • Small children who are born with poor vision cannot tell you their vision is poor – they are unaware that others have better vision.
  • Most causes of poor vision are easily correctable if they are picked up and treated on time.
  • The human brain learns to see from birth until about 71/2 years of age.
  • If there is a problem with one eye that blurs the vision then the part of the brain that processes vision from that eye will not develop properly and instead the brain devotes all its efforts to the other eye. This is called amblyopia or lazy eye.
  • Treatment of lazy eye works better in younger children and is fairly unlikely to work after the age of 71/2.

Who needs an eye test and when?

  • Any child who develops a squint (turn) in the eye or says they can’t see should have an eye test when the problem is noticed, as should any child with a droopy eyelid.
  • Any child with a close relative who has a squint or lazy eye should be examined when they are about 3 years old.
  • All children should have an eye test between 41/2 and 51/2 years of age (this is often done in schools by the nurse, but if your children have not had the test at school make separate arrangements)
  • Any child with headaches should have an eye test – headaches can be caused by long- sight, unbalanced eye muscles and by inflammation in the eye.

Why do children wear glasses?

  • Some children wear glasses simply to see better
  • Some children wear glasses because the glasses stop them squinting (turning their eyes)
  • Some children wear glasses as part of the treatment of lazy eye (amblyopia)

How do you treat lazy eye?

  • Many children with lazy eye have a difference in the focus between the eyes and need glasses as the first step of their treatment
  • Wearing a patch on the good eye forces the brain to use the information from the lazy eye and improves the vision development
  • Sometimes Atropine eye drops are used to blur the good eye (often when a child finds the patch very difficult to wear) so that the brain uses the lazy eye
  • For some children drops and patches are equally good treatments but for others patches are much better 

I think my son might be colour blind – what should I do?

  • Colour blindness is very common in boys and extremely rare in girls. In boys it is passed on through the mothers genes (“X linked”).
  • It is not treatable and does not cause any problems growing up.
  • There are some careers that you are unable to follow if you are color blind so it is worth knowing in your teenage years if you are colour blind or not. Before this age it is not really relevant unless the vision is bad.

When I took a photo of my child one eye showed “red eye” and the other did not – is that important?

  • The red eye seen in photos is a reflection of light from the retina (the seeing part of the eye).
  • If there is a dark shadow in the pupil instead of red eye it can be cataract (cloudiness in the lens of the eye).
  • If the red eye looks white instead of red there may be an abnormality of the retina which changes its appearance.
  • In most cases there is a simpler explanation – that the angle of the picture means that more light is reflected from one eye than the other, or the focusing optics of one eye are different to the other affecting the way the reflection appears.
  • Ophthalmologists (eye doctors) and opticians have special instruments to thoroughly examine the retina to make sure that there is no abnormality. 


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