children vision problems

Choosing the right glasses for your child

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Just the thought of buying eyeglasses for your child can make you want to pull your hair out. First, there is the initial selection to consider. Second, you must consider what your child is willing to wear. Third, which eyeglasses will be the most durable?

Then there is the pressure from your child, who is likely more worried about what the other kids might say and if their glasses look cool to others.

We’ve seen how stressful this process can be. Don’t worry, we’re here to help make it a lot smoother for everyone involved.

As noted by Liz DeFranco of AllAboutVision.com, there are other variables to this journey such as what kind of glasses are needed (near- or farsighted) and how often will they be worn.

Here are DeFranco’s 10 items to consider when buying kids’ eyewear.

1. Lens Thickness

It’s important to consult with the optician about the eyeglass prescription before looking at frames. Stronger lenses are likely going to be thick, so it is important to keep the frames as small as possible to reduce the final lens thickness.

2. Fashion

Sadly, other kids might comment with either nice compliments or unnecessary jokes about your child’s eyeglasses. It is important your child is comfortable with his/her new specs so don’t let them choose ones that you think might be a cause for concern with other kids later.

The goal is to get your child to wear the glasses.

3. Plastic or Metal

Children’s frames are made of either plastic or metal. Boys’ frames have double bridges while girls’ frames have single frames, which can also be unisex.

Plastic frames in the past were considered a better choice for children because they were more durable, less likely to be bent or broken, lighter in weight and less expensive.

Now manufacturers are creating metal frames to incorporate these features as well.

Also, ask for hypoallergenic materials if your child has shown sensitivity to certain substances, such as nickel.

4. Proper Bridge Fit

Children’s noses aren’t fully developed which makes this a tough part of the consideration process. They don’t have a bridge to prevent plastic frames from sliding down, but metal frames are usually made with adjustable nose pads to fit everyone’s bridge.

5. Temple Style

Temples that wrap all the way around the back of the ear, called “cable temples,” help keep glasses from sliding down or falling off your child’s face completely.

Another option is a strap that goes around the head.

6. Spring Hinges

A nice feature to look for is temples with spring hinges because kids aren’t always careful when they put on or take off glasses. Spring hinges can prevent the need for frequent adjustments to be made to the glasses.

7. Lens Material

Children’s lenses should be made of polycarbonate or a material called Trivex because the lightweight materials are more impact-resistant than other lens materials. They are also lighter in weight, have built-in protection from damaging UV rays, and are scratch-resistant coated by the manufacturer.

The least desirable material is glass. It must be treated for impact resistance, but it still shatters when it breaks which can be hazardous to the eye.

8. Sports Eyewear

If your kid plays sports, a proper sports goggle with polycarbonate lenses will provide the best protection against an eye injury. These goggles also must be fitted properly.

9. Warranties

If your child is a toddler or a first-time wearer, opt for a warranty if it’s offered. Not all warranty plans are the same, but it can be useful in case the eyewear needs to be replaced or fixed.

10. Backup Pair

It’s always good to have a backup pair of glasses because kids aren’t always the gentlest being to their belongings. Another pair might be best especially for those with strong prescriptions and wouldn’t be able to function without their glasses.

Ask your optician if special discounts apply for second pairs, especially if they’re purchased at the same time as the primary pair.

Learning-Related Vision Problems

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There’s no question that good vision is important for learning. Experts say more than 80% of what your child is taught in school is presented to them visually.

To make sure your child has the visual skills they need for school, the first step is to make sure your child has 20/20 eyesight. You’ll want to ensure any nearsightedness, farsightedness and/or astigmatism is fully corrected with glasses or contact lenses. But there are other, less obvious learning-related vision problems you should know about as well.

Good vision is more than 20/20 visual acuity

Your child can have “20/20” eyesight and still have vision problems that can affect their learning and classroom performance. Visual acuity (how well your child can see letters on a wall chart) is just one aspect of good vision, and it’s not even the most important one. Many nearsighted kids may have trouble seeing the board in class, but they read well and excel in school.

Other important visual skills needed for learning include:

  • Eye movement skills – How smoothly and accurately your child can move their eyes across a printed page in a textbook.
  • Eye focusing abilities – How well they can change focus from far to near and back again (for copying information from the board, for example).
  • Eye teaming skills – How well your child’s eyes work together as a synchronized team (to converge for proper eye alignment for reading, for example).
  • Binocular vision skills – How well your child’s eyes can blend visual images from both eyes into a single, three-dimensional image.
  • Visual perceptual skills – How well your child can identify and understand what they see, judge its importance, and associate it with previous visual information stored in their brain.
  • Visual-motor integration – The quality of your child’s eye-hand coordination, which is important not only for sports, but also for legible handwriting and the ability to efficiently copy written information from a book or chalkboard.
  • Deficiencies in any of these important visual skills can significantly affect your child’s learning ability and school performance.

Many kids have vision problems that affect learning

Many kids have undetected learning-related vision problems. According to the College of Optometrists in Vision Development (COVD), one study indicates 13% of children between the ages of 9 and 13 suffer from moderate to severe convergence insufficiency (an eye teaming problem that can affect reading performance). The study also concluded as many as one in four school-age children may have at least one learning-related vision problem.

Signs and symptoms of learning-related vision problems

There are many signs and symptoms of learning-related vision disorders, including:

  • Blurred distance or near vision, particularly after reading or other close work
  • Frequent headaches or eye strain
  • Difficulty changing focus from distance to near and back
  • Double vision, especially during or after reading
  • Avoidance of reading
  • Easily distracted when reading
  • Poor reading comprehension
  • Loss of place, repetition, and/or omission of words while reading
  • Letter and word reversals
  • Poor handwriting
  • Hyperactivity or impulsiveness during class
  • Poor overall school performance

If your child exhibits one or more of these signs or symptoms and is having problems in school, call us to schedule a comprehensive children’s vision exam.

Comprehensive children’s vision exam

A children’s vision exam includes tests performed in a routine eye exam, plus additional tests to detect learning-related vision problems. These extra tests may include an assessment of eye focusing, eye teaming, and eye movement abilities. Also, depending on the type of problems your child is having, we may recommend other testing, either in our office or with a children’s vision and/or vision development specialist.

Vision therapy

If it turns out your child has a learning-related vision problem that cannot be corrected with regular glasses or contact lenses, then special reading glasses or vision therapy may help. Vision therapy is a program of eye exercises and other activities specifically tailored for each patient to improve their vision skills.

Vision and learning disabilities

A child who is struggling in school could have a learning-related vision problem, a learning disability or both. Vision therapy is a treatment for vision problems; it does not correct a learning disability. However, children with learning disabilities may also have vision problems that are contributing to their difficulties in the classroom.

After your child’s comprehensive vision exam, we will advise you about whether a program of vision therapy would be helpful. If we don’t provide the services we believe your child needs, we will refer you to a children’s vision specialist or education/learning specialist who does.

Eye Exams for Children

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As a parent, you may wonder whether your pre-schooler has a vision problem or when a first eye exam should be scheduled.

Eye exams for children are extremely important. Experts say 5 to 10% of pre-schoolers and 25% of school-aged children have vision problems. Early identification of a child’s vision problem is crucial because, if left untreated, some childhood vision problems can cause permanent vision loss.

When should kids have their eyes examined?

According to the American Optometric Association (AOA), infants should have their first eye exam at 6 months of age. They should go back to the eye doctor around age 3, then again at about age 5 or 6.

For school-aged children, the AOA recommends an eye exam every two years if no vision correction is required. Children who need eyeglasses or contact lenses should be examined annually.

Early eye exams also are important because children need the following basic visual skills for learning:

  • Near vision
  • Distance vision
  • Eye teaming (binocularity) skills
  • Eye movement skills
  • Focusing skills
  • Peripheral awareness
  • Eye/hand coordination

Scheduling your child’s eye exam

Your family doctor or pediatrician likely will be the first medical professional to examine your child’s eyes. If eye problems are suspected during routine physical examinations, they may refer an optometrist for further evaluation. Eye doctors have specific equipment and training to help them detect and diagnose vision problems.

When scheduling an eye exam, choose a time when your child is usually alert and happy. Specifics of how eye exams are conducted depend on your child’s age, but an exam generally will involve a case history, vision testing, determination of whether eyeglasses are needed, testing of eye alignment, an eye health examination and a consultation with you regarding the findings.

After you’ve made the appointment, you’ll fill out a form all about your child’s health. The health history form will ask about your child’s birth history (also called perinatal history), such as birth weight and whether or not the child was full-term. Your eye doctor also may ask whether complications occurred during the pregnancy or delivery. The form will also inquire about current medications and past or present allergies.

Be sure to tell your eye doctor if your child has a history of prematurity, has delayed motor development, engages in frequent eye rubbing, blinks excessively, fails to maintain eye contact, cannot seem to maintain a gaze while looking at objects, has poor eye tracking skills or has failed a pediatrician or pre-school vision screening.

Your eye doctor will also want to know about your child’s previous ocular diagnoses and treatments like surgeries and glasses or contact lens wear. Be sure you inform your eye doctor if there is a family history of eye problems requiring vision correction, such as nearsightedness or farsightedness, misaligned eyes (strabismus) or amblyopia (“lazy eye”).

Eye testing for infants

It takes some time for a baby’s vision skills to develop. To assess whether your infant’s eyes are developing normally, your eye doctor may use one or more of the following tests:

  • Tests of pupil responses evaluate whether the eye’s pupil opens and closes properly in the presence or absence of light.
  • “Fixate and follow” testing determines whether your baby can fixate on an object (such as a light) and follow it as it moves. Infants should be able to perform this task quite well by the time they are 3 months old.
  • Preferential looking involves using cards that are blank on one side with stripes on the other side to attract the gaze of an infant to the stripes. In this way, vision capabilities can be assessed.

Eye testing for pre-school children

Pre-school children can have their eyes thoroughly tested even if they don’t yet know the alphabet or are too shy to answer the doctor’s questions. Some common eye tests used specifically for young children include:

  • LEA Symbols for young children are similar to regular eye tests using charts with letters, except that special symbols in these tests include an apple, house, square and circle.
  • Retinoscopy is a test that involves shining a light into the eye to observing how it reflects from the retina (the light-sensitive inner lining of the back of the eye). This test helps eye doctors determine the child’s eyeglass prescription.
  • Random Dot Stereopsis uses dot patterns to determine how well the two eyes work as a team.

Eye and vision problems that affect children

Besides looking for nearsightedness, farsightedness and astigmatism (refractive errors), your eye doctor will be examining your child’s eyes for signs of these eye and vision problems commonly found in young children:

  • Amblyopia. Also commonly called “lazy eye,” this is decreased vision in one or both eyes despite the absence of any eye health problem or damage. Common causes of amblyopia include strabismus (see below) and a significant difference in the refractive errors of the two eyes. Treatment of amblyopia may include patching the dominant eye to strengthen the weaker eye.
  • Strabismus. This is misalignment of the eyes, often caused by a congenital defect in the positioning or strength of muscles that are attached to the eye and which control eye positioning and movement. Left untreated, strabismus can cause amblyopia in the misaligned eye. Depending on its cause and severity, surgery may be required to treat strabismus.
  • Convergence insufficiency. This is the inability to keep the eye comfortably aligned for reading and other near tasks. Convergence insufficiency can often be successfully treated with vision therapy, a specific program of eye exercises.
  • Focusing problems. Children with focusing problems (also called accommodation problems) may have trouble changing focus from distance to near and back again (accommodative infacility) or have problems maintaining adequate focus for reading (accommodative insufficiency). These problems often can be successfully treated with vision therapy.
  • Eye teaming problems. Many eye teaming (binocularity) problems are more subtle than strabismus. Deficiencies in eye teaming skills can cause problems with depth perception and coordination.

Vision and learning

Experts say that 80% of what your child learns in school is presented visually. Undetected vision problems can put them at a significant disadvantage. Be sure to schedule a complete eye exam for your child prior to the start of school.