Eyesight in children

As your child grows and develops, their vision will improve. Most children at:

• 4 to 5 weeks old start to focus on faces and objects
• 2 to 7 months old begin to look at their hands and interact with their reflection
• 1 to 2 years old can recognise faces, and focus on near and far objects
• 3 to 4 years old will be able to see most lines of an eye test chart
• 4 to 6 years old develop their reading skills and recognise letters

Vision problems can slow areas of their learning and development. These include:

• physical skills, like crawling and walking
• language and social skills, like talking and playing

Some common eye conditions in children are:

• astigmatism — blurry vision caused by a slight change in shape of the lens or cornea in your eye
• hyperopia or long-sightedness — close objects appear blurry
• myopia or short-sightedness — far away objects appear blurry
• strabismus — where the eyes point in different directions
• amblyopia — where vision is unclear in one or both eyes

Strabismus is also known as 'squint', and amblyopia is also known as 'lazy eye'. Lazy eye can develop if a squint is left untreated.

It might not be obvious if your child has problems with their vision. This is because your child's eyes might look normal. However, you might see a change in their behaviour or how they use their eyes.

Some things to watch out for in babies are if:

• their eyes don't follow your face or another object
• they don't react to bright light
• their pupils appear white or cloudy
• their eyes look towards their nose or look outward
• they don't make eye contact with you or others

Toddlers and pre-schoolers with visual problems might:

• hold things up close to their face
• rub their eyes a lot
• see better during the day
• say their eyes are tired
• appear to have eyes looking in different directions
• fall or trip over a lot

If your child is not seeing well, they may:

• squint or partially close their eyes to see things in the distance or close up
• sit very close to the television or computer, or hold books close to their eyes to see
• tell you they can't see the whiteboard or screen at school
• rub their eyes a lot or complain of sore eyes
• appear to strain to see things clearly
• experience headaches

Young children assume that what they see is normal, and they may not tell you if they're having trouble. That's why regular visits to an optometrist are important.

Screen time

Looking at computer screens, such as tablets and smartphones, for a long time can cause:

• discomfort
• fatigue
• blurred vision
• headaches
• dry eyes
• eyestrain

Australian guidelines recommend that:

• children under 2 years don't watch screens at all
• children aged 2 to 5 years have less than 1 hour of screen time a day

Sun damage

Wearing a hat, and sunglasses that meet Australian Standards, can help protect your child's eyes from sun damage.

UV radiation can cause short-term irritation, with lots of blinking and sensitivity to bright light.

UV radiation can also cause longer-term problems, such as:

• damaged eyes
• skin cancers
• cataracts
• macular degeneration

Eye injuries

You can prevent eye injuries by keeping your child away from potential dangers around the house and garden, such as:

• chemicals
• paints and pesticides
• sharp objects including coat hangers, cutlery, and pencils

Remember to make sure that:

• you and your child always wear correct eye safety equipment
• your child plays with age-appropriate toys

If your child injures their eye, see an optometrist or ophthalmologist (eye doctor). They can assess the injury and provide treatment.

If the injury is serious, go immediately to your nearest emergency department or call triple zero (000) and ask for an ambulance.

In Australia, you will be offered an eye check shortly after your baby is born. However, their eyes develop quickly, and vision problems can happen as they grow.

In the early years, your child should have regular appointments with your child and family health nurse or doctor. They will have their eyes checked as part of their appointment.

It's also recommended that your child has an eye and vision check by a qualified eye health professional:

• before your child starts school
• every 2 to 3 years throughout primary and secondary school
• if your child's eyes change in appearance
• if your child experiences changes to their vision
• if your child has a family history of eye conditions

Some of the eye health professionals your child may see for eye tests include:

• optometrists
• orthoptists
• ophthalmologists

You don't need a referral from your doctor to get an eye test with an optometrist or an orthoptist.

There are different levels of blindness that affect people in different ways. A child is considered legally blind when they can't see an object at 6 metres that a child with normal vision can see at 60 metres.

The term 'legally blind' is used by the government to define someone whose vision impairment entitles them to special benefits.

Your child is considered to have low vision when they have permanent vision loss that:

• affects their daily life
• can't be corrected with glasses

Blindness and vision impairment can be caused by many things, including:

• genetic conditions, like retinitis pigmentosa and albinism
• injury to the eye
• damage to the nerves that connect the eye to the brain
• conditions that affect the parts of the brain that control vision
• conditions like cataracts and glaucoma
• infections during pregnancy, from viruses like rubella or sexually transmitted infections

Vision problems are diagnosed with an eye test. In young children, optometrists use symbols and pictures to test near and distance vision. If a child can't understand the tests, they may be shown different sized stripes.

Your child's peripheral vision — what they can see outside their field of vision when they're looking straight ahead — will also be tested.

Functional vision assessments

If your child's vision is impaired, it's a good idea to get a functional vision assessment. This assessment can:

• test if your child's vision is developing as it should
• help you learn how well your child can see
• provide ideas and strategies to make daily life easier
• help you find out how your child's vision impairment is affecting other areas of their development

If you think there's a problem with your child's eyesight, it's important to get it checked.

See your doctor or optometrist, who can refer you to a children's eye specialist (paediatric ophthalmologist) if needed.

Some states and territories offer free vision screening programs to children at around 3 or 4 years of age. You can ask your child health nurse or preschool if screening is available where you live. Medicare covers eye tests for children by an optometrist once every 3 years.

Medicare does not cover glasses or contact lenses, but you might be able to access state or territory funding schemes.

Not all optometrists bulk bill. Ask your optometrist if you will have any out of pocket costs when you make your appointment.

Private health insurance with optical benefits cover may help you pay for prescription glasses or contact lenses. Check with your private health insurer what is included in your policy.

It might take your child a little while to get used to wearing glasses. But it's important for their long-term vision that they wear them as advised by their optometrist.

Ensure glasses fit properly

The first step is to make sure your child's glasses fit well. Ensure they're comfortable – not too tight or loose – and that your child can see through them clearly.

If the glasses start to slip off, or your child is having trouble seeing well, go back to the optometrist, and they can adjust the glasses.

Choose durable glasses

It's a good idea to select strong, durable frames and scratch-resistant lenses. If you can, buy a back-up pair in case the first pair gets lost or damaged.

Find role models

If your child doesn't want to wear their glasses, point out that a lot of people wear glasses. Show them role models they know who wear glasses — such as relatives, friends, public figures, book characters, musicians or actors. Even Harry Potter wears glasses!

Introduce glasses slowly

You can 'introduce' the glasses gradually, through a part of your child's routine they enjoy, such as reading a book, or watching a movie. Eventually wearing glasses will be part of their daily routine.

Being consistent is key — for example, putting on glasses after breakfast and praising your child every morning will help them remember to put them on.

You can teach your child how to care for their glasses. For example, never put them on a surface with the lenses facing down, since this can scratch them.

If the glasses get dirty, wipe them with a soft cloth. Keep them in a case when not in use.

Remind your child to always be gentle with their glasses — never throw them, bend them or let other kids try them on.

Early intervention services

If your child is diagnosed as blind, they will be able to use early intervention services. This will help your child's skills develop and provide emotional support for your family.

Early intervention services include seeing various health professionals such as:

• orthoptists
• physiotherapists
• occupational therapists

For more information:

• Visit your GP — you might be referred to see an optometrist.
• Speak to your child health nurse.
• Use the Service Finder tool to find an optometrist near you and check if they bulk bill.
• Read more on how Services Australia can help with the costs of children's health care, including vision care. You can also get financial support through the NDIS on 1800 800 110.

Services for children with severe vision impairment or blindness

There are services that can help you and your child with daily life, treatment, information and emotional support. These include:

• Good Vision for Life for information about your child's vision and signs that your child might have vision problems
• Vision Australia — you can also call them on 1300 84 74 66
• Guide Dogs Australia