Author: Vanessa Thai
Developmental and Behavioural Optometrist
Central Health Southside – Child Development Team
Children’s vision is an integral component of their overall development. Visual health is essential for learning, social interactions, and safety. Studies have shown connections between academic success and visual ability. Up to 80 percent of learning is done through visual processing in the first 12 years of life. Still, one in five children has an undetected vision problem.
Good vision is important for:
- Safety – impaired vision can lead to accidents and injuries, especially while children are playing and on the move
- Education – good vision is vital for learning and maximising academic potential
- Higher quality of life – allowing children to enjoy and engage in their favourite activities
- Fostering independence – being able to perform everyday tasks helps build confidence
- Strengthening emotional well-being – poor vision limits a child’s ability to interact with the world and may lead to frustration, anxiety, and depression
- Social interaction – effective communication involves being able to recognise faces, make eye contact, and read facial expressions
- Career opportunities – impaired vision can limit career choices and advancement opportunities.
The human eye is a remarkable organ that allows us to perceive and understand the visual world. Vision, more than the ability to see clearly, involves the development of focusing ability, eye coordination, depth perception, eye muscle action, visualisation, and peripheral vision. It also encompasses a child’s ability to capture, process, and interpret visual information.
As parents, we can learn to identify signs and symptoms of potential vision problems and seek help.
Appearance:
- Eyes not pointing at the same object
- Wandering eyes or droopy eyelids
- Teary, red eyes or encrusted eyelids
- Recurring bump or stye on eyelid
- White pupil or uneven pupil size
- Eyes moving or wobbling involuntarily
Behaviour:
- Frequent blinking, frowning, and eye rubbing
- Squinting, closing, or covering one eye
- Head tilting and holding objects close to the face
- Sitting closer to the television or other screens
- Displaying poor hand-eye coordination
- Being clumsy and frequently bumping into objects
- Avoiding or becoming irritable during close-up tasks (20-40 cm)
- Losing interest quickly or having a short attention span
- Falling asleep while looking at books
Complaints:
- Double or blurred vision
- Light sensitivity and regular head/eye-aches
- Difficulty recognising familiar faces in the distance
Common vision problems:
- Amblyopia – lazy eye or blurry vision due to a communication error between the brain and eye
- Strabismus – crossed or misaligned eyes
- Refractive errors –
- Myopia (shortsightedness) – trouble seeing clearly in the distance
- Hyperopia (longsightedness) – trouble focusing up close
- Astigmatism – the front of the eye is oval-shaped resulting in blurred vision at all distances
Some children are more at risk of developing vision problems due to prematurity (of less than 32 weeks completed gestation) or a family history of vision disorders.
Who To See
To maintain good vision and ensure early detection of potential problems, regular eye exams are essential. Even if the child’s vision seems fine, routine check-ups can help identify issues before they become more serious.
Optometrists are eyecare professionals who play an important part in eye health. They detect, diagnose, and treat eye conditions and abnormalities. They not only test vision and eye health, but they can also be the first health practitioners to identify general health problems that may be diagnosed during an eye examination and provide referrals to other health professionals. An optometrist’s scope of practice may include:
- Refraction – measuring the optics/prescription/power of the eye
- Binocular vision evaluations – testing the coordination of the two eyes as ateam
- Ocular health tests – checking the front to back of the eyes for diseases
- Optical dispensing – supplying spectacles, contact lenses, and eye drops
- Ophthalmology co-management
- Diabetic eye exams
- Colour vision test
- Vision therapy
- Myopia management
When Should Children Have Their First Eye Check-up?
In the first few years of life, a child’s visual system undergoes rapid development and is highly adaptable. Regardless of their age, an eye exam is recommended at the first signs of a suspected vision problem because early detection is crucial in the treatment success and prevention of further issues.
The Hong Kong Department of Health recommends that all children have a comprehensive eye examination by a Part 1-registered optometrist before they begin school (at age 4), followed by annual checks throughout their schooling years to monitor their eye health and vision development.
Many vision disorders are treated by wearing prescription glasses. To allow children the opportunity to enjoy play and learning, gain skills, and reach their fullest potential.
Parents’ role in children’s vision development:
- Reading together to encourage stronger visualisation skills
- Encouraging healthy visual hygiene – good even lighting, an appropriate distance (forearm’s length) from close-up tasks, and regular breaks
- Incorporating daily outdoor play with varied activities including games, climbing, exploring, and building (wear sunglasses and a hat to lessen UV exposure)
- Encouraging play dates to develop visual skills
- Encouraging activities to stimulate visual processing (e.g. memory games) and hand-eye coordination (e.g. sports, puzzles, blocks, drawing, and cutting)
- Encouraging good nutrition; a balanced diet including fruits, vegetables, nuts, and fish to provide essential antioxidants that support and maintain eye health
- Limiting TV and screen time where possible
Pregnancy
Pregnancy and parents’ eyes
Like the body, eyes can experience multiple changes during pregnancy due to fluctuations in hormone levels. These fluctuations can lead to distorted or blurred vision, dry eyes, and floaters (spots and shadows in your field of vision). It is important that parents also have regular eye examinations, as many eye problems are hereditary. Therefore, identifying eye problems in parents will in turn benefit their children.
