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Seeing Clearly: Eye Care Tips for Your Child

By Dr. Annick Fournier, Acting Chief, CHEO Ophthalmology

How many times have you told your children to move away from the television or to stop making their eyes cross because it's bad for their eyes? And how do you know whether it really is bad for their eyes?

Here is some basic eye health information to help you sort through what’s true and what’s not.

What are some normal milestones in eye development?

Babies' eyes tend to wander until they are about 10 weeks old. At that point their eyes come into alignment and babies will fix on items that are within 36 inches (about 1 metre). By eight months old, they are able to fix their eyes and follow on something that is as far as 20 feet (about 6 metres).

Some eye problems, such as wandering or crossed eyes, are easier to treat if they are caught before children’s eyes reach maturity at the age of eight.

When will my child's eyes be checked?

Your family physician or pediatrician will test your child's eyes at or before six weeks old. At this point they are looking specifically for the red reflex. Parents can check for the red reflex by taking a picture straight on of their open-eyed baby in a dimly lit room, using a flash. The picture should show that both eyes are red the same way. If there is any significant difference between the eyes or there are any white, gray or black spots, you should follow up with your doctor as soon as possible.

The doctor will check your child's vision at about age three and a half. If there are no problems and concerns (see signs and symptoms below), your child will probably only need to be checked again every three to five years afterward.

If there is an eye disorder in the family, the child has a general illness of some sort or was born prematurely; you may want to discuss this with your doctor sooner. If you have any concerns or suspicions, you should discuss them with your doctor at any time.

What are the signs and symptoms that my child may have eye problems?

Sometimes children develop habits or give us clues about how their eyes are doing. Children of any age who tend to close only one eye in bright sunlight, very often have a wandering eye which needs to be followed up by a doctor. Some children will squint which tells us that they may need glasses. This squinting should be distinguished from the rapid blinking habit that some kids develop and which is not related to their vision. Kids who play at going cross-eyed are not endangering their eye health.

Parents should consult their doctor if they notice any of the following:
  • A wandering eye or eyes that just don't look straight (in children more than 4 months old);
  • Eyes that are dancing about, never still;
  • A cloudiness, either in the front of the eye (cornea) or inside the eye;
  • An eye that continually runs water or has a lot of discharge;
  • A red eye or an eye that the child is constantly rubbing;
  • A droopy eyelid that may be interfering with sight;
  • A child who is constantly holding or tilting his or her head to one side;
  • A child who squints the eyes or acts as if there is a vision problem.

What should I do if my child's eyes are hurt?

Minor injuries and infections to the eyes are quite common and often do not require a visit to the doctor. Here are some common problems and what to do about them.

Red or pink eye

If the eyes are red and itchy, it is probably due to allergies. These have no serious impact on eye health and can be treated with drops. Consult your pharmacist. If the eyes are red and have discharge, the child may have an infection or 'pink eye'. These are often treated with over-the-counter drops, however, you should consult your doctor to make sure this is the best choice for your child. If the eyes are red, are painful, light sensitive or tearing, see a doctor.

You should consult an eye doctor if there is:
  • Pain in your child's eye.
  • A loss of vision.
  • An injury or blow to the eye.
  • Discharge.
  • Haziness or cloudiness of the cornea.
  • Redness of the eyelids.
  • Unequal pupil size.
  • Bright red blood inside the eye.
  • Change in your child's red reflex.
Parents don’t need to worry about how close their children sit to the TV. Children with normal vision can see well from a few inches to about 20 feet away (about 6 metres). There is no more concern for eye health between being a few inches from a computer screen and a few inches from the TV. Of course, if your child is blocking the TV for the rest of the family, then that's a different issue!


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