Our ophthalmologists at ABC Eyes answer the most frequently asked child vision questions.
What is Amblyopia?
Amblyopia is poor vision in an eye that did not develop normal sight during early childhood. It is sometimes called “lazy eye”. When one eye develops good vision while the other does not, the eye with poorer vision is called amblyopic. Read more about Amblyopia.
What can a baby see?
Babies have poor vision at birth but can see faces at close range, even in the newborn nursery. At about six weeks a baby’s eyes should follow objects, and by four months should work together. Over the first year or two, vision develops rapidly. A two-year-old usually sees around 20/30, nearly the same as an adult.
What are the signs of poor vision in a child?
Parents should be aware of signals of poor vision. If one eye turns or crosses, that eye may not see as well as the other eye. If the child is uninterested in faces or age-appropriate toys, or if the eyes rove around or jiggle (nystagmus), poor vision should be suspected. Other signs to watch for are tilting the head and squinting. Babies and toddlers compensate for poor vision rather than complain about it.
How do you know if a baby or young child needs glasses?
Should a baby need glasses, the prescription can be determined accurately by dilating the pupil and analyzing the light reflected through the pupil from the back of the eye. Prescriptions for glasses can be measured in even the youngest and most uncooperative children by using a special instrument called a retinoscope to analyze light reflected through the pupil from the back of the eye.
Children outgrow crossed eyes.
Children do not outgrow truly crossed eyes. A child whose eyes are misaligned has strabismus and can develop poor vision in one eye (a condition known as amblyopia) because the brain turns off the misaligned or “lazy” eye. The sooner crossed or misaligned eyes are treated, the less likely the child will have permanently impaired vision.
All children with small amounts of farsightedness, astigmatism, and nearsightedness need glasses.
Eye glasses are necessary only when the vision of the eye(s) is significantly reduced or, in some cases, when the eyes cross due to excessive farsightedness.
What is a Blocked Tear Duct (Nasolacrimal duct obstruction)?
Obstruction of the tear duct will cause tearing or watering of the eye because the tears cannot drain properly. Symptoms of a blocked tear duct include eyelashes that are stuck together by mucus or an accumulation of tears in one or both eyes. The tears trapped within the duct may become infected, causing a painful swelling in the inner corner of the eyelid. In infants the membrane that causes the obstruction will usually open by six months of age. If this does not occur, your physician will often recommend treatment to open the blockage.
How is a blocked tear duct treated?
Initial treatment involves massaging the area over the affected tear sac (located under the skin between the eye and nose) to force the tears and mucus from the sac, hopefully pushing open the membrane causing the obstruction. In infants, this massage requires the active involvement of the parent, as it must occur frequently. Massage is generally continued until the tearing resolves. Antibiotic drops or ointments may also be prescribed by the physician in the event of infection. If the obstruction is still present, it may be necessary to open the tear duct by probing and irrigation. This is most commonly performed between six months and one year of age. The probing is done by passing a thin probe down the tear drainage system in an attempt to open the blockage. There is minimal pain associated with this procedure. After the probing, there may be some brief blood staining of the tears or a slight nosebleed. Antibiotic drops may be prescribed. This procedure is 90-95% effective after the first treatment. Unfortunately, blockages may recur in spite of probing. If the tearing persists, then a small tube may be placed down the duct to keep the tear draining system open. The tubes are tiny and generally imperceptible, and usually remain in place for six to twelve months to prevent the obstruction from recurring.
What is a chalazion and how is it treated?
The term chalazion (pronounced chah la’ ze on) is derived from the Greek word meaning small lump. It refers to a cystic swelling with chronic inflammation in an eyelid. A gradual enlargement can be felt near the margin of the lid due to the swelling in one of the eyelid oil glands (meibomian).
Treatment may involve any one or combinations of the following: antibiotic and/or steroid drops or injections, warm compresses, massage, or expression of the glandular secretions, surgical incision or excision.
Large chalazions which do not respond to other treatments can be surgically opened after the early inflammation is reduced. Surgical intervention in children is performed under general anesthesia.
What is Retinopathy of Prematurity (ROP)?
Retinopathy of Prematurity (ROP) damages premature babies’ retinas, the layer of light-sensitive cells lining the back of the eye. ROP usually occurs in both eyes, though one may be more severely affected. Read more about Retinopathy of Prematurity (ROP).
What is Strabismus?
Strabismus refers to misaligned eyes. If the eyes turn inward (crossed), it is called esotropia. If the eyes turn outward (wall-eyed), it is called exotropia. One eye can be higher than the other, which is called hypertropia (for the higher eye) or hypotropia (for the lower eye). Strabismus can be subtle, (occurring occasionally), or constant. It can affect one eye only or shift between the eyes.
Read more about strabismus.