Vision and eye health in children

Vision and eye health in children

Development of the visual system begins prenatally and continues after birth. However, owing to how personal and subjective a person’s sight is, children may not realise they have a vision problem. Sight problems in infants can cause developmental delays, therefore, early detection and management are essential in ensuring children have the opportunity to develop the visual abilities they need to learn. Pharmacists and healthcare professionals should be aware of the stages of vision development, as well as common eye conditions that present in childhood, in order to best support, advise and refer patients when necessary.

Stages of vision development

·        Infancy (birth to 3 years)

A baby’s vision improves rapidly over the first few months of their life[1], with the ability to judge distance (depth perception) developing at around five months of age. By two years of age, a child’s hand-eye coordination and depth perception should be well developed[1].

·        Preschool (age 3–5 years)

Development of accommodative facility (ability of the eye/s to focus on stimuli at various distances and in different sequences in a given period), vengeance ability (movement of both eyes in opposite directions to obtain or maintain single binocular vision) and eye movements continues until the child is around five years of age. Toys, games and playtime activities help this by stimulating the process of vision development. Children should have a thorough, in-person optometric eye examination at 3–5 years of age to ensure that their vision is developing properly and there is no evidence of eye disease before they begin school.

·        School age (age 6–18 years)

Vision changes can occur without a child or parent noticing them. To reduce the risk of this happening, children aged 6–18 years should receive an eye examination every two years, or more frequently if specific problems or risk factors exist or if recommended by an ophthalmologist[2]. The most common vision problem is nearsightedness (myopia); however, some children have other forms of refractive error, such as farsightedness and astigmatism. Problems with eye focusing (the ability to quickly and accurately maintain clear vision as the distance from objects changes), tracking (the ability to keep the eyes on target when looking from one object to another) and coordination may affect school and sports performance (see Box 1)[3]. Box 1: Signs that may indicate vision problems in a school-age child

Parents should be advised to look out for the following signs in their child:

  • Frequent eye rubbing or blinking;
  • Short attention span;
  • Avoidance of reading and other close-distance activities;
  • Frequent headaches;
  • Covering one eye;
  • Tilting the head to one side;
  • Holding reading materials close to their face;
  • An eye turning in or out;
  • Seeing double;
  • Losing place when reading;
  • Difficulty remembering what he or she read.