By Eyecare NG

Infants   |  Preschool Children   |   School Children 

Good eyesight (vision) is essential for learning and development. Unfortunately, many children with eye problems, especially infants and preschoolers, go untreated. This is because most of them do not realize they have an eye problem and those who feel uncomfortable with their eyes and vision are unable to communicate their problem effectively. Therefore, it is important that parents, teachers and other child caregivers are able to identify the signs and symptoms of eye problems in children.

Common signs and symptoms of eye problems in children of different ages are outlined below.

Infants (Birth to 24 months)

  • Watery eyes: This may be a warning sign of eye irritation, increased eye pressure or blocked tear ducts. A foreign body in the cornea, for instance, can cause irritations that result in watery eyes. Also, high pressure in the eye due to a condition like congenital glaucoma can cause watery eyes in infants.
  • Rubbing the eye: Children rub their eyes when they feel itchy, uncomfortable or like something is in them. This can be caused by an allergy or a foreign body in the eye.
  • Large eyeball: An unusually large eyeball, especially if it is the cornea that is more prominent, could be due to congenital glaucoma.
  • Red eye: This is usually associated with viral or bacterial conjunctivitis.
  • White pupil: White pupil (also known as leukocoria) could be due to an opaque lens or a tumour in the eye. An opaque lens in infants is a result of a congenital cataract. On the other hand, an eye tumour that can cause white pupil in children is retinoblastoma.
  • Discharges and crusts on the eyelids: Yellow-green or milky discharges could indicate that an infant has a bacterial eye infection.
  • The closing of one eye/drooping of one eyelid: If a child frequently closes one eye or has one of the eyelids drooping, it may be a sign that a child has amblyopia (lazy eye).
  • Light sensitivity: Unusual sensitivity to light in an infant could be due to increased pressure or inflammation in the eye.
  • Eye turning inwards or outwards: If a child’s eye turns inwards or outwards constantly or intermittently, the child may have crossed eyes (squint).
  • Failure to make an eye contact and lack of attraction to light: A child that does not make eye contact during breastfeeding and is not attracted to light or bright colours may have very poor vision or may be seeing at all.

Preschool children (3 years to 5 years)

In addition to the signs and symptoms of eye problems in infants, the following may indicate that a preschool child has an eye problem;

  • Poor eye-hand coordination: Eye-hand coordination is the ability of the brain to use information received from the eyes to effectively direct hand movement. It requires the simultaneous use of visual and motor skills to perform tasks. Poor eye-hand coordination may present as poor handwriting and reading skills, avoidance of writing and reading activities, attention deficiency as well as difficulty playing with toys or games like catching the ball. Eye problems that may cause poor eye-hand coordination include double vision, crossed eyes and amblyopia.
  • Headache, eye fatigue and discomfort: These may be due to refractive errors like myopia (short-sightedness), hyperopia (long-sightedness) and astigmatism. It may also be due to binocular vision problems.
  • Bringing toys too close to the eyes: This may be an early sign of shortsightedness.
  • Moving close to the television: Generally, preschool children are attracted to images on the television and always go close in a bid to touch them. However, children who have difficulty seeing far objects (short-sightedness) also do this. So, it is important to monitor this behaviour and determine whether it may be associated with an eye problem or not. You could do this for instance by checking if the child brings objects too close to the eyes or moves too close to the board in the class.
  • Bumping into obstacles: Frequently bumping into objects could also be a sign of an eye problem
  • Head tilt and neck twist: Children who have double vision or other binocular vision problems may tilt their heads to get a better view of objects.

 School children (6 – 18 years)

In addition to the signs and symptoms of eye problems in infants and preschool children, the following may indicate that a school-aged child has an eye problem;

  • Difficulty reading or copying what is on the board: A child who finds it difficult reading or copying what is on the board without move very close to it may have a refractive error.
  • Using the finger to guide the eye, losing place, skipping words or jumping lines while reading: These may be due to a refractive error or binocular vision problem.
  • Squinting: A child with a refractive error like astigmatism may squint in order to see clearly.
  • Reading and/or writing difficulties: A child who has a refractive error or binocular vision problem may experience reading difficulties.  The child may not see prints clearly, may have a headache or eyestrain while reading and may avoid reading. The same goes for writing and other near tasks
  • Lack of concentration or attention: Functional vision problems like poor convergence, poor visualization and poor tracking can cause a child to lose focus, make careless mistakes or fidget while performing a task.
  • Low grades in school: This could also be a sign of an eye problem. Hence, the eyes of a child that is not performing well at school needs to be examined to ensure that he/she is not struggling with his eyesight which in turn affects his learning and performance.