From the May 2016 issue

Signs Your Child Has a Vision Problem

Do you suspect your child may be having trouble seeing – or another eye abnormality? A Children's Hospital of Michigan expert weighs in with common signs.

A child’s eyes are incredibly important tools that help them observe and absorb the world. From learning to read at home to seeing the board at the front of the classroom, vision plays a vital role in life and learning as kids grow.

So how might you know your child’s vision isn’t quite sharp enough? The issues aren’t always easy for parents to pick up on right away. But lucky for mom and dad, there are still a few behaviors to watch for that could signal a problem – and pediatricians have a number of ways to screen for issues of the eyes.

What to look for

For parents at home, identifying an issue with your child’s sight is somewhat dependent on the child’s age, explains Dr. John Roarty, chief of the department of ophthalmology at Children’s Hospital of Michigan in Detroit.

“In pre-verbal children or little ones – especially leading up to kindergarten – sometimes you may not know they have a vision problem unless something else is going on,” he notes.

Some common signs of a vision problem might be if your child is getting really close to objects to see them well, like walking up close to the television – “or they don’t seem to see things off in the distance,” Roarty notes. Maybe you notice the eye wanders across or drifts, or your child squints when focusing. These are helpful signs when looking for an issue in a younger child’s sight.

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In older children, it’s easier to recognize vision issues because your child is more capable of telling you they are having problems seeing at school, for example. Parents should also take note if they notice their child has frequent headaches, complains of blurred vision or isn’t progressing in school.

The Michigan Department of Health and Human Services has a vision screening program for children conducted by schools and the local health department, which will look for eye abnormalities such as muscle misalignment, nearsightedness and farsightedness in preschoolers between ages 3 and 5 as well as first, third, fifth, seventh and ninth graders, MDHHS notes.

“It’s state law that every child has to have a vision exam” before entering kindergarten, Roarty notes.

Another reason to have your child’s vision checked early on? “If you do have a child that is known to have some sort of neurologic or developmental problem, those kids have a higher risk of having some sort of vision or eye muscle problem,” he says.

Treating a vision problem

If you suspect a vision problem, a good first step is to make an appointment with your child’s primary care physician. Primary care physicians can also screen for any other type of developmental delays to weed out other root causes that may be contributing to setbacks in an area like reading or learning.

In older kids, the doctor will have them read a traditional eye chart with letters of varying sizes to determine a problem. But for younger kids who don’t yet know their letters, doctors can use a photo screener, which is essentially a camera that takes a photo of the eye and “creates that red reflex that we all don’t like in our holiday pictures,” Roarty says. This actually will uncover if the child is nearsighted, farsighted or if his or her eyes are misaligned.

An ophthalmologist might check how your child’s eyes fixate and follow an object. “Many pre-verbal kids cannot tell you what letter they see,” he notes, so doctors will “rely on fixation or tracking.”

There are even options for kids who are older but don’t know their letters quite yet, he says. Doctors will give kids matching tests, which require kids to pair up common shapes and letters.

Should doctors find a vision or eye muscle problem, it can be treated right away through various methods depending on the findings, which may include eyeglasses, eye exercises or even a patch for a condition like a lazy eye, Roarty says.

If the family has hereditary eye issues or parents see an eye muscle problem, they may consider making an appointment with a specialist and doing so earlier on.

To make an appointment with the experts at Children’s Hospital of Michigan’s department of ophthalmology, visit childrensdmc.org/pediatric-ophthalmology or call 313-745-KIDS.

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