Your Toddler's Vision

By Dr. Elise Brisco

Toddlers learn by observing the world around them, yet they are too young to know if they have a vision problem. Because a child cannot compare how he sees to anyone else, he does not know what is “normal”. This is why it’s especially important for parents to recognize signs of vision problems. Unfortunately, most vision problems have no symptoms, so the best way to rule out a vision problem that can interfere with learning and development, is to have your child’s eyes checked yearly beginning at 6 months old. Early detection is critical in preventing and treating vision conditions that can affect your child’s success in school, and life for years to come.

Vision is the most important system for learning. Most research indicates that 80% of learning occurs through the visual system. Obvious problems such as an eye turn are usually detected by a pediatrician; however, many vision problems are not. A pediatric vision screening is usually only a cursory screening of distance visual acuity (far vision). A comprehensive vision examination should evaluate for fine motor development such as tracking and eye teaming, near vision (reading distance), depth perception, amblyopia (lazy eye), and ocular health problems. Certain problems, if not caught early, can become lifelong problems interfering with academic, athletic and eventually executive achievement.

Signs of possible vision problems in toddlers include:

• Squints to see when there are no bright lights or glare
• Tilting or turning head to one side
• Clumsiness
• Lack of interest or avoidance of books, puzzles, and other visual activities
• Rubbing eyes when not tired
• Sitting too close to television or computer
• Holding books or toys too close or too far
• Closes or covers one eye often
• Excessive sensitivity to light
• Has milky colored or cloudy pupils (emergency)
• Crusty lids
• Red eyes
• Tearing not related to crying
• Eyes that constantly move back and forth
• Headaches associated with prolonged visual activities
• Double vision
• Difficulty recognizing colors, shapes, letters or numbers

A recent retrospective study of comprehensive pediatric eye examinations reported the following as the most common disorders in children 6 months to 18 years of age seen in an optometrist’s office:

• Hyperopia (farsightedness):  24.8%
• Astigmatism:  22.5%
• Myopia (nearsightedness):  18.2%
• Nonstrabismic binocular disorders:  14.3%
• Strabismus (crossed or wall eye):  12.1%
• Amblyopia (lazy eye):  7.1%

A developmental vision evaluation for infants and toddlers is very different than an adult’s. We have a Pediatric Optometry department in our practice. We can determine if your child is in need of vision correction even though your child does not read yet. Dr. Brisco did one of her post doctorate Fellowships in Developmental Vision. There are special tests and techniques that we perform to evaluate your child’s vision. We will check eye movement, eye alignment, reaction to light and darkness, visual acuity, stereovision, and eye health. We will make recommendations to correct and prevent vision problems. Treatment options include Developmental Vision Therapy, visual guidance activities, and prescribing of lenses for stimulation and development of the visual system.

If you have any questions about a child’s eye exam, please call our office at (323) 954-5800.