Children's eyes are not just a miniature version of adult eyes, but are in constant development from birth until around the age of 9. During this period children's eyes are vulnerable to developmental abnormalities. Problems such as refractive errors, i.e. the need for glasses, or strabismus can lead to «lazy eye» amblyopia, which can be permanent unless treated early.
Refractive abnormalities are the most common eye problem for children. These abnormalities are myopia, hyperopia and astigmatism. When they are present in only one eye they are even more difficult to detect, as the child shows no signs that he or she is not seeing well. Early prescription of glasses in these cases is imperative to improve vision and avoid amblyopia. Particularly for school-aged children, glasses can make a big difference in the proper functioning of children in the classroom. Most children in small classes who need glasses do not complain that they do not see well, causing them to fall behind in the school schedule and become introverted. It is recommended that all children be examined by an ophthalmologist before kindergarten even if there does not appear to be a vision problem or a family history of glasses.
Strabismus is another major childhood eye problem. It is the condition in which the eyes are not in alignment. One eye sees straight, while the other eye is turned in another direction. Half of strabismus is congenital and is treated early before the age of 2 years. The other half, however, appear at school age. Some strabismus needs glasses, others surgical correction and some need both.
Even if strabismus is suspected, an examination by an ophthalmologist is necessary. Timely correction of strabismus is necessary to restore the cooperation of the two eyes and to avoid amblyopia of the most strabilised eye. In addition, correction of strabismus restores the aesthetic appearance of the child and avoids any psychological effects.
Amblyopia, «lazy eye», is usually the result of both of the above problems, unequal refractive errors or strabismus. Its treatment consists of prescribing glasses for refractive errors and correcting strabismus. In addition, the healthy eye is covered for a few hours a day (usually after school) to enhance the vision of the lazy eye. This treatment of amblyopia can be continued until the age of 9 years, beyond which it is impossible to improve vision.
It is important for parents to seek immediate evaluation by an ophthalmologist if their child has poor vision or strabismus. It is possible, with proper diagnosis and early treatment, to prevent most childhood vision problems.
