Image Credit: Supplied

As a parent, you might wonder what goes on behind your child’s eyes as they start to make out shapes and faces. How they see the world might be inconceivable, but what should not remain a mystery is their eye health. Are they squinting to see objects far away, or complaining about headaches? It may be time to take your child to an ophthalmologist for a comprehensive eye exam.

“It is advisable to do a comprehensive examination before five years of age, even without any symptoms,” says Dr Julia Sempere Matarredona, Consultant Paediatric Ophthalmology, Barraquer Eye Hospital, Dubai. “These examinations can include visual acuity test, extraocular movements, complete exploration of the eye, dilatation of the pupil and assessment of the retina. However, if parents see any symptoms, such as unusual movement of the eyes, inwarding or outwarding, or abnormal red reflex or asymmetry between both eyes then we advise that they should see an ophthalmologist.”

Dr Julia Sempere Matarredona Barraquer Eye Hospital, Dubai

As your child grows, their eyes can change quickly. The paediatrician will likely screen your child’s vision as part of their regular checkups. “Your child’s vision can change a lot over the course of a year,” says Dr Tarek Younis, Ophthalmologist, Medcare Eye Centre. “For instance, an infant will only focus with both eyes at the age of three months unless there is a development issue.”

Dr Darakshanda Khurram, Consultant Paediatric Ophthalmologist and Strabismologist and Chief of Paediatric Ophthalmology Service at Moorfields UAE, says babies, in general have their eyes examined before being discharged from hospital. “Red reflex should also be checked at the same time,” she advises. “In case there is a family history of eye conditions, the first comprehensive eye check should be at the age of one, otherwise I advise parents to check their child’s vision before they turn three years of age.”

As the eye size is continuously changing during the first 12 years of a child’s life, so is the vision. Dr Khurram says, “Children are born farsighted as the size of the eye is small. They grow into their power. Visual activities, near tasks and outdoor activities impact vision development according to the child’s needs.”

Dr Tarek Younis Medcare Eye Centre

Common vision problems

As vision develops, children are also vulnerable to eye problems with age. Hence, it is crucial to ensure healthy vision, as eye problems in children can affect their ability to perform daily activities such as reading, playing, writing etc.

Among the main eye problems in children is lazy eye or amblyopia. This means the child develops vision in one eye but not both. It is particularly important to be detected in early childhood, before 5-6 years old, to have a solution. Amblyopia therapy can include glasses, patching, eye drops, and sometimes surgery.

Dr Darakshanda Khurram Moorfields UAE

“Refractive issues such as astigmatism, farsightedness (hypermetropia) or nearsightedness (myopia) are also most common in children and adults and are most often caused by abnormalities in the surface of the eye that prevent light from properly being focused on the retina,”says Dr Matarredona.

Other common concerns could be tearing, redness, misalignment of the eyes, and itching or droopy eyelid.

Impact on learning

Poor vision can affect learning by lowering reading or comprehension skills. Our eyes must work together effectively to move across a page, make sense of letters, and understand what is written. Children with a vision-related learning problem will typically lose their place while reading and confuse similar looking words because they can’t properly see the text.

“If your child has a vision problem, they may struggle to stay on task and understand assignments, both of which can lead to slipping grades,” says Dr Younis. “Poor vision is not limited to visual acuity (the ability to see clearly), but children can also experience problems with hand-eye coordination.”

Dr Khurram agrees, “As the majority of the learning skills are vision based, for example reading, writing and motor skills, having reduced vision not only causes a child to struggle with school activities, but it also impacts their confidence and level of involvement in class-based learning.”

Contact lenses for kids

If your kid’s glasses are getting in the way of their football game or if they’ve lost or broken too many frames to count, you might consider contact lenses. But is it a good idea to give contact lenses to kids?

According to Dr Matarredona children as young as eight years of age may do well with contacts, while some teens may not be ready to handle the responsibility. “Eye care providers often won’t advise contacts for children younger than 12 years of age,” she says. “This is because the risks often outweigh the benefits in younger children. However, sometimes we can recommend it in children earlier to practice some sport or in particular circumstances, but this is always under parental supervision and advice of their eye health caregivers.”

While agreeing that children as young as eight years old can start part-time contact lens wear for sports or any stage-based activities, Dr Khurram contends that “for those kids who have significant refractive errors such as myopia or hypermetropia and are reluctant to participate in contact sports, contact lenses could be excellent”.

However, Dr Younis says he wouldn’t advise contacts for children younger than 14 years of age. “This is because the risks often outweigh the benefits in younger children,” he says. “Children who are 14 years old and older are usually able to handle the responsibility of managing contact lenses.”