More than 75 percent of an infant’s learning happens by seeing. Without seeing, it’s hard for little ones to learn what to do and how to act. So much of social development and motor development happens through the eyes: reading facial expressions and body language and learning to respond effectively forms the basis of burgeoning communication skills.
According to the American Academy of Pediatrics , vision disorders are the fourth most common disability in the United States. And yet recent studies conclude that only 21 percent of preschool age children are screened for vision problems. The AAP (American Academy of Pediatrics) recommends eye exams beginning at birth and continuing with every checkup.
But how can you know if your young child can see adequately or not? Children don’t tell you what they can’t see. They aren’t even aware of what they can’t see; they tend to think the way they see the world is just the way it is, since they didn’t have visual acuity to lose.
The problem is compounded of course, with the preverbal or nonverbal child, who can’t tell you much of anything descriptive anyway. But even the most verbally precocious preschooler who insists on telling you every single mundane plot detail of “Dora the Explorer” may never express inadequate vision. The child simply accepts his vision of the world the way it is.
And yet, diagnosing and treating loss of vision in the young child is critical. A child’s visual development is considered to have reached maturity around the age of ten, so vision problems that were not detected or communicated before this stage are likely to never be corrected to normal levels. The child’s brain will use its marvelous ability to adapt, and quickly learns to suppress an abnormal image.
The three most common causes of vision impairment in young children are: nearsightedness, or myopia; farsightedness or hyperopia; and astigmatism, causing a distorted image. Most children, and indeed most adults, seem to have a combination of astigmatism and either myopia or hyperopia. These vision errors are commonly corrected through prescription lenses, or eyeglasses.
Premature babies, or ones with very low birth weight, have a higher incidence of nearsightedness and astigmatism and may even need to have corrective lenses before they are even one year old. There is a higher rate of vision defects among children with Downs’ syndrome as well.
Simply gaining visual clarity is not the only reason for correcting these visual problems with eyeglasses. More importantly, if problems with vision are not corrected in early childhood, these could result in amblyopia. Amblyopia occurs when uncorrected vision problems actually lead to permanent changes in the vision center of the brain. Once a child has gained so-called visual maturity around the age of ten, interventions like eyeglasses are much less likely to show improvements.
There are reasons to delay the use of eyeglasses, though, and that would largely be up to the child’s ophthalmologist. One reason is that young children are notoriously unwilling to keep glasses on their face. Expense is another one; glasses are expensive and to have them used as a toy might not be productive. And there is some evidence that eyes tend to repair themselves, and vision can correct naturally. An ophthalmologist may be reluctant to interfere with the eye’s natural drive to good vision.
If it’s so important to begin corrective measures early, and little children can’t tell us what they don’t see, what should parents and caretakers be looking for? An article at StLukesEye.com suggests the following.
First of all, look at family history. A family history of visual problems indicates a need for a complete vision screening by three years of age. Even in the absence of impaired vision in the family history, parents and caretakers should still be on the lookout for these signs:
Pupil color. If the pupil is white, this could indicate a type of cataracts or tumerous growth.
Rubbing, blinking, or squeezing eyes. In many children, this is a sign they are tired, hungry or even have allergies. However, these behaviors are also common in children having a hard time focusing their vision. If you notice these behaviors occurring at times other than nap or bedtime, you may want to schedule a vision screening.
Winking a lot. Sometimes a child will close one eye while reading or looking at television due to blurred, or double vision.
Headaches. Sometimes headaches in children are a sign of eye strain. Struggling to look at a page or a chalkboard can strain eyes that have difficulty seeing. This is probably why many vision problems aren’t noticed until the child is in school.
Odd behavior. This one is tricky, but sometimes children who seem to be hyperactive, have attention deficit disorder, and other learning difficulties are merely frustrated with poor vision. It’s wise to have a vision screening if any of these conditions are addressed in school before assuming a learning disability.
Early detection and intervention is crucial to preventing these vision problems from impacting adolescence and adulthood, so if you notice any of the symptoms above, consult your pediatrician for a pediatric ophthalmologist referral.
