Learn to identify common vision concerns in children younger than 4 years of age. By recognizing vision concerns and their symptoms early on, you will know when your child needs to see an eye doctor.

How developed is my child’s vision?

Babies can see at birth, but they have to learn to use their eyes. They have to learn how to focus, track objects and use both eyes together. Babies learn eye-hand coordination and the distance of people or things.

By about 1 year of age, children are able to judge distances, and they have good eye-hand-body coordination for grasping, holding and throwing things.

During the preschool years, children further develop vision skills needed for eye-hand coordination and fine motor skills. They also learn how to recognize colours, shapes, letters and numbers.

Children’s vision continues to develop as they grow, but issues become more difficult to correct at older ages. This is why it is important for all children to have a full eye exam by kindergarten entry, to ensure any vision issues are addressed during this important time of visual development.

Should vision problems be corrected at an early age?

Yes, some vision concerns need to be corrected at an early age. Some vision concerns or changes can be difficult to detect or notice without testing. You need to correct some concerns early to prevent permanent vision damage:

• Crossed eyes (strabismus) is a condition where the eye muscles point one or both eyes in the wrong direction
• Lazy eye (amblyopia) is a condition where the vision in one eye is weaker than the other eye. The child's brain ignores the weak eye and uses the strong eye to see. Treatment needs to commence (i.e within the early childhood years. If untreated, the child's brain develops a clear picture in the strong eye and a blurry picture in the weak eye.

Vision concerns often have a family history. If you know of vision concerns in your family, your child's eyes should be examined by an eye doctor (optometrist or ophthalmologist) by 3 years of age or earlier, especially if you notice any concerns. Optometrists recommend the first routine eye examination, regardless of any concerns, between age 6 to 12 months.

What signs and symptoms should I watch for?

 Your child should see your family health care provider or eye doctor if you notice any of these signs or symptoms:

• Red, itchy, watery eyes discharge
• Squinting or rubbing the eyes
• Excessive blinking
• Drooping upper eyelid
• Covering or closing one eye
• Tilting or holding the head in an unusual position
• Sensitivity to light
• Lack of concentration
• Holding objects too close
• Complaining of a sore head
• Avoiding activities needing distance vision
• Difficulty finding or picking up small objects
• Trouble focusing or making eye contact
• Eyes appear crossed or turned
• Difficulty following objects or people
• Avoiding books or screens
• Bumping into things

What can I expect at my child's vision test?

Your child can have an eye exam even if your child does not talk or read yet. An eye exam will not be uncomfortable for your child. The eye doctor will show your child the equipment before the tests.

The eye exam may check your child's:

• Eye health
• Eye muscle movement
• Ability to see clearly
• Ability to tell the distance of objects
• Ability to see colours

How can I help to prevent eye injuries for my child?

You can reduce the risk of eye injuries and increase eye safety for children by doing the following:

• Do not allow your child to play with sharp items such as darts, scissors or sharp toys. The use of age-appropriate scissors should be supervised
• Keep your child or toddler away from older children who are playing with sharp objects
• Teach children not to walk or run while carrying sharp objects, such as pencils, popsicle sticks or scissors
• Keep your child away from power tools, lawn mowers or chemicals
• Limit your child’s screen viewing to no more than 1 hour per day for ages 2 to 4. It is recommended that children under age 2 have no screen time
• Keep children at least 3 metres (8 to 10 feet) away from the TV screen. Place the television in a spot that reduces glare or use soft lighting

What about wearing sunglasses and other types of protection?

Ultraviolet (UV) rays from the sun can cause eye damage, as well as harm the skin. Sunglasses are recommended for children and adults. To protect eyes, sunglasses should:

• Have large lenses and a wraparound design, fully covering the eyes
• Fit well and be comfortable
• Have labels with 99 to 100 per cent UVA and UVB protection
• Come off easily if any cords or strings are attached and pulled. There is a risk of strangulation if the cords or strings do not come off easily

If your child wears corrective lenses or glasses, make sure they have UV protection.

Hats that shade the face and eyes may be an alternative for sun protection. Hats can be easier for children to keep on than sunglasses.

Could my child be colour blind?

Some children, males more often than females, have trouble seeing certain colours. Your child can have a simple colour vision test by an eye doctor to check for any concerns.

For More Information

For more information, see:

• HealthLinkBC File #11 Ultraviolet Radiation
• HealthLinkBC File #53b Elementary School Age Children and Their Vision

For information on vision screening, contact your local public health unit.

To find an optometrist in your area, contact the BC Doctors of Optometry at 604-737-9907 or toll-free 1-888-393-2226, or visit https://bc.doctorsofoptometry.ca/.