Out of Focus


Vision problems in children aren’t always easy to detect. The symptoms can be subtle or mistaken for misbehavior or lack of interest in school.

“Children often do not realize there is a problem and accept their vision as it is,” explains Dr. Jonathan H. Salvin, ophthalmologist at Nemours/Alfred I. DuPont Hospital for Children in Wilmington, DE.

Optometrists can treat most common vision problems among school-age children, explains Dr. Lance Dunoff, optometrist at Fox Chase Family Eye Care in Philadelphia, but it’s important to catch and treat them early to avoid more serious issues.

Here are the most common vision problems in school-age children, the symptoms to watch for and how doctors treat the disorders.

Refractive errors

A refractive error means that the shape of the eye doesn’t bend light properly, causing images to appear blurred. The most common vision problem children have is myopia, or nearsightedness. Children with myopia can see objects up close clearly but have poor distance vision. Hyperopia, or farsightedness, causes objects nearby to appear blurry. Astigmatism causes objects to appear blurry or distorted at any distance.

“Some children can outgrow refractive errors over time,” says Dr. Amy Wexler, pediatric ophthalmologist at South Jersey Eye Physicians in Moorestown, NJ. “But it is very difficult to predict whether that will happen.” Eye doctors can correct all three refractive errors with eyeglasses or contacts.

Strabismus and amblyopia 

When a child has strabismus, his eyes are misaligned and point in different directions. If left untreated, strabismus may develop into amblyopia, also known as lazy eye. With amblyopia, the brain favors one eye and eventually may ignore images from the weaker eye. Amblyopia also can result from one eye being nearsighted or farsighted or having more astigmatism than the other. Regardless of the cause, amblyopia can lead to irreversible vision loss in the weaker eye by late childhood if left untreated.

“Amblyopia remains the leading cause of monocular vision loss in children in the U.S., but it is also completely treatable in most cases,” says Dr. Salvin. Both disorders can be treated with a patch on the weaker eye, eye drops, specially designed glasses or surgery.

Symptoms to watch for

Signs of a possible vision problem in children may include:

  • Frequent eye rubbing, blinking or squinting
  • Difficulty reading
  • Short attention span
  • Lower level of comprehension with schoolwork
  • Trouble seeing distant objects
  • Headaches
  • Eyes moving in different directions
  • Covering or closing one eye
  • Seeing double
  • Dizziness

When to go to the eye doctor

Children may exhibit symptoms of an eye problem, but many do not, explains Dr. Salvin. The American Academy of Ophthalmology and the American Academy of Pediatrics both recommend that school-age children have their eyes checked every year by a pediatrician. Many schools perform vision screenings for their students as well.

If a school nurse or pediatrician detects a problem during a screening or if your child notices signs of a vision problem, make an appointment with an optometrist.

Is Screen Time Dangerous for Your Child’s Eyes?
As computer, tablet and cell phone use has increased in recent years, so have concerns about the effects of prolonged screen time on children’s eyes. Along with eye strain and discomfort, some doctors worry that prolonged exposure to the blue light the screens emit may cause retinal damage.

For overall health, the American Academy of Pediatrics recommends limiting the time school-age children spend in front of screens to no more than one to two hours per day for entertainment purposes. If you choose to, you can use filters for computer, cell phone and tablet screens to reduce blue light exposure.

Dr. Dunoff says, “We protect our kids with sunscreen so they don’t get melanoma down the line. We should be protecting our eyes from these devices in the same way.”

Susan S. Stopper writes frequently for MetroKids.


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