En Español: Los tres problemas de la vista más comunes en niños y cómo detectarlos

The back-to-school season is a whirlwind of activity for parents as families adjust to  the new academic year. Scheduling a wellness visit with the pediatrician is part of the routine for many parents, and it is also a perfect time to set up an eye exam for your child, since eye problems are surprisingly common in children.

The three most common vision disorders — refractive errors, amblyopia, and strabismus — are easily treatable. Eye problems can become more difficult to correct the longer they go untreated, and poor eyesight can affect the ability to read and focus — and can also impact social adjustment and behavior in school.

The signs of an eye problem — and how to spot them

Children with poor eyesight often will not complain, because they don’t know what it’s like to see clearly. They assume everyone sees the world the way they do. If you notice any of the below symptoms, schedule an eye exam for your child.

The three most common vision disorders experienced by children

Refractive errors: These are the most common vision disorders and include myopia (nearsightedness), hyperopia (farsightedness), and astigmatism (blurry vision). Nearsightedness affects as many as 18 out of 100 children in the U.S., depending on age and ethnicity, while farsightedness and astigmatism affect as many as 28 out of 100 kids.

Amblyopia: This condition occurs when one eye is weaker than the other because it is not working properly with the brain. It is found in about three to five out of 100 children in the U.S. and is commonly referred to as “lazy eye.” Amblyopia can be the result of another problem, such as refractive errors, cataracts, and strabismus.

Strabismus: This condition occurs when the eyes are not aligned properly. They cannot focus together on a single point, which can affect depth perception. In addition to being a cosmetic disorder, strabismus can lead to vision loss if not corrected, because the brain may learn to ignore the input of one or both eyes. Strabismus affects two to four out of 100 children under age 6.

While a routine vision screening can indicate a problem, only an eye specialist can provide the exam, diagnosis, and treatment needed to correct and preserve your child’s vision. Treatment for all three of these disorders begins with prescription eyewear to treat the eye that is weakened or roaming or to correct refractive issues to enable your child to see clearly both near and far away. In the case of amblyopia or strabismus, to strengthen the weaker eye your doctor may prescribe eye drops to blur the stronger eye or a patch to cover the stronger eye for periods of time. If eyeglasses and an eye patch or eye drops don’t work, corrective surgery may be considered to adjust the muscles that align the eyes. This same-day outpatient surgery has a long track record of success.

Five things you can do to keep your child’s eyes healthy

1. Get kids outside: Sunlight is beneficial for eye health. Get your child some cool sunglasses — they don’t interfere with the benefits — and send them outside to play.

2. Feed them a balanced diet: A well-rounded diet with plenty of different fruits, vegetables, and leafy greens provides essential nutrients for growing eyes, including vitamins A, C, and E, omega-3 fatty acids, lutein, and zinc.

3. Protect their eyes from injury: Children of all ages are at risk for eye injuries, whether they’re just learning to walk or getting into sports. Limit the potential for harm by providing age-appropriate toys, securing dangerous household chemicals, avoiding consumer fireworks like sparklers, and making sure your child has the appropriate eye protection equipment for sports.

4. Adopt the 20/20/20 rule: For every 20 minutes of screen time, take a 20-second break to focus on something at least 20 feet away. You can use a timer to help your kids adopt this eye-health habit. Also remind them to blink to avoid dry eyes.

5. Get your kids’ eyes checked regularly: Screening begins at birth, and pediatricians are the first line of defense for your child’s eye health. Eye specialists rely on them to conduct screenings in early childhood, referring children with vision disorders for care. Between birth and age 2, pediatricians screen for eye abnormalities during wellness visits. They examine the external structures of the eye and check eye muscle balance, the health of pupils, motility (movement), and the health of eyelids and orbits. They also perform “red reflex” exams to screen for inside-the-eye abnormalities.

From age 3 to 5, pediatricians should continue vision screenings. During these years, each eye may be assessed individually by placing a cover over one eye as the child recites letters, shapes, or images off of an eye chart. This test can reveal a weakness in one eye, which hinders the ability to have balanced vision.

After age 5, children should continue to have their eyes checked at pediatric wellness visits. Because kids’ eyes grow and change, vision screenings are a regular part of your child’s overall health care. If a screening indicates a vision problem at any age, an eye exam by an ophthalmologist is the next step.

Regular eye exams are especially important if your child has a chronic condition such as diabetes, sickle cell anemia, or a rheumatoid disorder.

Montefiore Einstein: at the forefront of children’s eye health

If your child needs the care of an eye specialist, the Department of Ophthalmology and Visual Sciences at the Children’s Hospital at Montefiore is one of the largest and most experienced pediatric ophthalmology services on the East Coast. Our ophthalmologists are at the forefront of the pediatric field, regularly publishing academic findings and mastering the latest procedures. Dedicated to helping children improve and maintain their vision, we provide treatment and services across a broad spectrum of disorders that affect the eyes. Our approach to care includes research aimed at providing every patient with the most innovative treatment options available.

To make an appointment with one of our pediatric eye doctors, call (718) 920-2020.