Introduction

Children do not fully develop their vision until they are eight. Vision will develop quickly in your child’s first few years before slowing down. 

Physical problems with eyes can cause vision issues, which can affect their general health, learning and development.

It is important to check your child’s eyes regularly to make sure any problems are picked up and treated quickly.

 Signs and symptoms

Some signs and symptoms of problems with eyes or vision include:

  • an unusual or white colour in the pupil, which is the black circle in the middle of the eye
  • oozing or watering from the eyes that does not go away or comes back often
  • one eye looking turned in a different direction
  • eyes not moving well or smoothly
  • being extremely sensitive to light or glare
  • your child always tilting or turning their head to one side
  • your child holding toys and books very close to their face
  • your child sitting very close to the television
  • differences in how your child’s eyes look - for example, one being bigger than the other.

See your local doctor as soon as possible if you notice any issues with your child’s eyes or vision.

Diagnosis

Your local doctor can check your child’s eyes and vision and refer them to a specialist doctor for any issues.

An eye specialist is called an Ophthalmologist. They will look at your child’s eyes and vision more closely, talk to you about symptoms and medical history, and run any relevant tests and scans.

A full eye test is recommended for all babies and children when they:

  • have a family history of having crossed eyes, also known as strabismus
  • need strong glasses at an early age due to a refractive error, where light is unable to focus correctly due to the shape of the eye
  • are born prematurely, before 36 weeks of pregnancy
  • are diagnosed with a developmental delay.

A vision test is important for all children before they start school. The StEPS program run by NSW Health provides free vision screening to all children aged four years old living in NSW.

Some common eye problems in children include:

  • strabismus - also known as crossed eyes
  • amblyopia - also known as lazy eye
  • chalazion - lumps that form in the duct that drains tears into the nose, called the tear duct
  • epiphora - also known as watery eyes.

Treatment

Treatment of common eye problems will depend on the specific issue and how severe it is. Your child’s doctor will recommend the best treatment for their eye problem and how to manage it at home.

 Management

Strabismus – crossed eyes

Strabismus is also known as:

  • turned eyes
  • crossed eyes
  • squint
  • lazy eyes.

Strabismus is when the eyes point in different directions, including inwards, outwards, up, or down. It can happen continually or only at certain times.

Strabismus can be found when your child is born or may develop later. The condition can cause issues with vision in the affected eye and is not something your child will grow out of.

Treatment for strabismus needs to be started as early as possible. It can include:

  • wearing special glasses
  • using eye patches
  • doing eye exercises
  • surgery
  • a combination of the above.

Your child will see an ophthalmologist and vision specialist called an orthoptist to treat strabismus.

When strabismus is treated early, your child should be able to have good vision and eye coordination.

Amblyopia - lazy eye

Amblyopia is commonly called lazy eye. It happens when one eye doesn’t move or work as well because it is not getting a clear picture, unlike the other eye.

Amblyopia can be caused by:

  • strabismus – crossed eyes
  • refractive error - where light is unable to focus correctly due to the shape of the eye
  • ptosis – a drooping eyelid that blocks vision
  • cataract – when the clear lens of the eye becomes cloudy.

Untreated amblyopia can cause your child to have very poor vision.

When treatment is started early, your child’s vision should improve. Your child’s doctor will talk to you about different treatment options depending on what is causing the amblyopia.

Chalazion - a lump in the eyelid

A chalazion is a small, swollen lump that forms when the upper or lower eyelid glands get blocked. This causes redness, pain, and sometimes oozing. 

There can be multiple chalazia forming at the same time, and they can happen in both eyes.

Chalazia can look like pimples, but you must not try to pop them.

Chalazia can be treated at home by using mild heat and gently massaging the eyelid toward the eyelid edge in a rolling motion at least three times a day.

Speak to your child’s doctor if any liquid comes from the eye. Your child may need antibiotic ointment or eyedrops to treat and prevent further infection.

Epiphora – watery eyes

Epiphora or watering eyes can happen when the tear ducts become blocked. It can also be a sign of other issues.

Blocked tear ducts should get better on their own. 

Minor surgery can be done to treat epiphora if: 

  • it keeps happening regularly past one year of age
  • your child gets infections in the tear duct regularly.

Resources and more information

STEPS - Statewide Eyesight Preschooler Screening

title
Statewide Eyesight Preschooler Screening (STEPS)

Biography
The StEPS program is an initiative of NSW Health and offers all 4 years old children free vision screening.
Related Links

Disclaimer

This factsheet is provided for general information only. It does not constitute health advice and should not be used to diagnose or treat any health condition.

Please consult with your doctor or other health professional to make sure this information is right for you and/or your child.

The Sydney Children’s Hospitals Network does not accept responsibility for inaccuracies or omissions, the interpretation of the information, or for success or appropriateness of any treatment described in the factsheet.


© Sydney Children’s Hospitals Network 2024