How to recognise eyesight problems in your child

Some of the signs of vision problems in children include:

• Regularly rubbing their eyes
• Squinting
• A noticeable ‘turn’ in the eye, or misdirection of the eye, such as crossed eyes
• Closing one eye or trying to obscure their vision (such as with a hand over one eye) when reading or looking at object
• Headaches
• Finding it difficult to pay attention and focus
• Sitting close to the TV, or holding screens or books very close to their face
• Trying to avoid activities like writing and reading
• Confusion when writing and reading
• Sensitivity to light or watering eyes
• Unusual clumsiness and problems with hand-eye coordination, like ball games
• A ‘white reflex’ in photos: this is similar to the ‘red eye’ that you sometimes see in photos, but it looks white and can be a sign of an extremely serious problem, so it’s vital to seek medical attention immediately 

 Eye checks are done at regular stages throughout early childhood, starting from birth.
 
Your child is likely to have vision screening as part of the School Entry Health Check, which is usually done in their Reception year at age four to five.
 
This generally takes place at school, and is considered important to identify eyesight problems that could affect their learning at an early stage, although it’s your right to decline screening. If they already wear glasses, their vision won’t be tested.
 
If a sight problem is detected in your child, they’ll be referred for further tests. This may be at a local optician’s practice, a community eye service or a hospital eye service.
 
While school entry vision screening can pick up on many eyesight problems, it’s important that your child has regular eye tests out of school, at a frequency recommended by your optician.  
 
‘Often, parents don’t realise there’s a problem with their child’s eyesight, so although there are some signs to look out for, we’d always recommend they have a proper eye examination,’ says Bayfields’ founder and managing director Royston Bayfield.
 
NHS eye tests are free for all under-16s. Your child doesn’t have to be able to read to have an eye test: there are other ways of checking their vision that don’t rely on reading the traditional chart, such as looking at pictures.
 
The person who performs your child’s eye test is called an optometrist, while a dispensing optician orders and fits glasses.

 There are many types of sight problems in children. Some of the most common include:
 
Lazy eye: one eye (or, unusually, both) struggles to develop a strong link to the brain, so they see less well out of that eye, and rely more on the ‘good eye.’ It affects around one in 50 children, and is harder to treat after the age of six.
 
Squint: one eye turns up, down, in or out, while the other looks straight ahead. Any squint that happens all the time should be checked out.
 
Short-sightedness (myopia): distant objects appear blurred while close objects are sharp. It often starts between the ages of six and 13.
 
Long-sightedness (hyperopia): close objects are out of focus while distant objects are clear. This is more common in adults, but does occur in children, and can lead to lazy eye or squint.
 
Astigmatism: the eye is shaped more like a rugby ball than a sphere. It usually occurs along with short- or long-sightedness. Uncorrected, it can cause lazy eye.
 
Colour blindness (colour vision deficiency): difficulty distinguishing between colours, usually red, yellow and green. It’s much more common in boys than girls.

How your child’s sight problems are treated will depend on the type of problem they have.
 
Usually, glasses are the first stage of treatment – and for some children, this is all they’ll need, with regular sight tests to check if their prescription has changed.
 
Children with a lazy eye may be given an eye patch to wear over the unaffected eye for a part of each day. This encourages them to use the lazy eye, instead of relying on the good one, so the two eyes eventually work equally well.
 
Children with a squint are often given eye exercises to work the muscles that control eye movement and get the eyes moving together. This may involve being referred to an orthoptist (a specialist in eye movement disorders) at an eye clinic.
 
In rare cases, surgery might be recommended to improve the alignment of the eyes, but if your child’s squint is recognised and treated at a young age, it’s less likely to be necessary.