How to Care for Your Child’s Eye Health

It can be difficult as a parent or carer to understand how to care for your child’s eye health, especially if they're at an age where they can't communicate if there's something wrong. Here are some in-depth pointers to consider when it comes to caring for your child’s eye health.

 

New borns (birth to 3 months)

New born babies really don’t see too well at all. This is mainly because the eyeball itself is very small, making them very long-sighted, and usually they cannot focus well past 8 or so inches. Their eyes may not move together in alignment all the time, and they will struggle to track an interesting or colourful object. This ability to follow an object or to respond to you smiling at them only develops from around 6 or so weeks old. If you notice however, that their eyes are always misaligned, or that they are unable to respond to you without using sound to get their attention, or if they become upset when one eye eye is covered more than the other, there may be a problem with their sight, and this should always be investigated via the GP.

If you have any immediate questions and would like to consult with one of our optometrists, you can book a remote consultation right here on Eyebou.

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Because tiny ones can’t focus so well at further distances, helping to stimulate their visual development by providing stimulus at close range is important. Black and white contrast cards can be really helpful because of the engaging shapes in high contrast that your baby can easily see. These cards will engage your child’s attention, stimulate the development of their optic nerves and help to build the connection between their eyes and their brain. They’re also soothing for your new born as they’re something that they can focus on easily when shown to them at close range.

From 2-3 months old, babies will start to recognise mum and dad’s faces, and will be able to start noticing different hues of colour. You’ll notice their eyes moving together as a team, and they will start to reach for things. 

You may like to check out BabySee, which is an innovative app that works as an infant vision simulator. It’s been built as an educational tool to allow parents to see the world through their baby’s eyes at each stage of their development.

 

6 - 12 months old

During these months, babies' eye-body coordination will be improving and their colour vision and depth perception increases quickly. With crawling, learning to stand and walking, eye coordination develops further, and encouraging these motor skills will also improve their sight development.

 

Toddlers

By around 2 years old, children who can see well are extremely interested in exploring their environment, and will have excellent recognition of familiar toys, objects and books.

 

Signs of vision & eye problems

The eye lid areas around babies and toddler’s eyes are particularly susceptible to blockages and infections due to the small size of the drainage architecture in them, so they may often get sticky, crusty eyelids. This is usually self limiting, and will clear up within a couple of weeks, but should be checked if causing them discomfort, failing to resolve on it’s own or if further issues develop, like swelling, sensitivity to light or new redness of the eyes.

If you notice one of the eyes constantly or intermittently turning, this could indicate an issue with the eye muscles and can impede the visual development of the affected eye and needs to be checked.

Another sign to look out for, which can indicate a potentially much more serious issue is the appearance of a white pupil instead of the usual “red eye” observed in a photo. This can indicate a particular type of eye cancer and needs to be checked urgently.

 

 2 - 5 years old

These years are key in building the strength of the connection between both eyes and the brain due to the plasticity of the brain during this stage of life. Identifying any factors that might be inhibiting the normal development of the eyes, or their ability to send information to the brain is key, as it can be very difficult to build on this connection after 5 - 6 years old.

During this time, it’s imperative to establish that both eyes are able to see well.  If for instance, one eye has a very different prescription to the other, or one eye has a muscular imbalance (so that it is turning or appears “crossed”), the connection between that affected eye and the brain will not form correctly, resulting in amblyopia (lazy eye). If amblyopia is present, it’s essential that it is assessed and managed, as this cannot be treated later on in life. Management is often in the form of occlusion therapy (patching of the better eye to aid the development of the weaker one), spectacles, and/or surgery to correct the muscle imbalance.

In the absence of a turning eye, you may have not noticed any signs that one of your children's eyes is seeing less well than the other, as they can see well with their better eye with both eyes open. You can check that both eyes are seeing to a similar level at home by asking a family member to cover one of the child’s eyes whilst you hold up fingers or picture cards 3 meters away. If the child is able to guess correctly with each eye, then it’s unlikely that they have amblyopia, however if they’re struggling to guess correctly with one of their eyes (or both), they should have their eyes checked.

While strabismus is different to amblyopia in that the former is known as 'squint' and the latter as 'lazy eye', you can test your child's eye health with a quick strabismus check on the Eyebou iOS app.

Download the Eyebou app

 

Additionally, parents and carers should be on the lookout for indicators of delays in development, for example, difficulties with recognising shapes, colours and numbers, which can occur if there’s a problem with vision. Children of this age group experiencing visual difficulties, may also avoid activities with visual detail like colouring or puzzles. They may also develop coping mechanisms to counteract eye muscle imbalances like tilting their head to one side, squinting their eyes or sitting very close to the T.V.

The following activities can be used to help further develop your child’s visual skills at home:

• Making plenty of time for outdoor playing, riding a bike, throwing and catching a ball
• Doing puzzles or block building with your child to help with eye-hand coordination
• Doing activities that require cutting out & colouring 
• Encouraging your child to play with other children
• Reading books with your child and encouraging them to follow along with what you’re reading

 

6 - 18 years old

Good vision is key for children to achieve their full potential in school, in both the classroom and with sporting and extracurricular activities.

If there is any impedance on a child’s sight, their abilities in; recognition, retention and comprehension may all be diminished. They may also be withdrawn, lack confidence or merely be frustrated a lot of the time, with learning being difficult and stressful.

Visual problems at this age group, if left undetected and untreated, can result in similar symptoms and signs attributed to ADHD, so please make sure you book annual eye tests for your child to avoid any misdiagnoses. 

If your child has myopia, astigmatism or eye muscle imbalances, it is important they are given the opportunity to see well if interested in sports, and so should be discouraged from removing their spectacles to take part in sports. The flip side of this is that the child’s spectacles may be heavy and unstable or uncomfortable on the face when playing or taking part in sports. If this is the case, please consult with your child’s optometrist to look at alternative solutions, of which there are many!

 

Time spent outside

Time spent outside is key to ensuring normal development of the eyes. A 10-year long study which looked at the development of myopia (short-sightedness) in children, found that children who spent a minimum of two hours outside, every day, developed less myopia than children who didn’t. The mechanisms involved in the elongation of the eye (which causes myopia) is not entirely known, however the diversity of visual stimuli found outside, including: textures, lighting condition and the opportunity to look at a multitude of different distances seems to have a very positive impact on stabilising the normal development of the eyes. This is especially important as large jumps in myopia result from increases to length of the eyeball, which left unchecked and unmanaged, affect the retinal health of the affected eyes.

For further information about how to care for your child’s eye health, please visit the College of Optometrists to read more.

This article was written by Mai Monavar, Eyebou's lead optometrist.