Sometimes a child’s eyes do not work together as they should. One eye may be ‘lazy’, or wander in or out, or up or down (strabismus). In such a case, the brain receives a different image from each eye. The brain may switch back and forth between the two images, or it may turn off the weaker image.

If it turns off one image, the child stops using that eye (amblyopia/lazy eye). One eye may be crossed all the time or or only under conditions of stress- when your child is tired, ill, or looking at nearby objects. Infants’ eyes normally wander but if one eye shows signs of wandering past the age of two or three months, your child needs eye care. Treatment may involve glasses, patching, eye-drops, or surgery.

Sometimes a child cannot see objects that are far away (near-sightedness) or objects that are close up (far-sightedness). A child can even be so far-sighted that both near and distant objects are blurred.

If the front of the child’s eye(cornea) is irregularly curved (astigmatism), objects look blurry at all distances. However, these common childhood vision problems can almost always be corrected with glasses or contactlenses. In some cases, vision problems can lead to amblyopia if not corrected.

Eye infections and injuries are common in children. Viral and bacterial infections spread quickly through classroom and day-care centers. Children can also be hit in the eye by sharp (pen/pencil) or blunt objects (ball). Eye infections and injuries need to be treated promptly, as some can cause permanent damage to the eye.

Pediatric eyes change rapidly, and problems can occur at any age. That is why it is important to observe your child’s eyes and to pay attention to his/her behaviour.

Anything unusual in the way your child’s eyes appear can be a sign of a problem. Watch for the following:

• Eyes that cross or one eye that turns in or out, or up or down.
• One eye that seems different in some way, such as a larger or smaller pupil.
• Eyes that look crusty, swollen, bloodshot, or red-rimmed.
• Eyes that water a lot.
• Any discharge, bleeding, or red bumps on the eye-lids.
• A pupil that shows a white rather than a red reflex in a colour photograph.

Unusual behavior can sometimes be a sign of an eye problem. Watch your child for any of the following warning signs:

• Closing one eye or turning or tilting the head to see things.
• Squinting to see things in the distance.
• Not seeing things you point out.
• Consistently holding objects close to the face or sitting very close to the TV (most children do this sometimes).
• Blinking, squeezing or rubbing one eye a lot.
• Running into objects or falling down at night or in places that aren’t well lit.

Once your child is school-age, he or she may be able to tell you about eye problems. Listen for mention of the following:

• Inability to see the blackboard at school.
• Things looking blurry or funny.
• Eyes that itch, burn, or feel scratchy.
• Getting hit in the eye, or getting something in one eye.
• One or both eyes hurting, or a pain in or around one or both eyes.
• Light making the eyes hurt.

Headaches and dyslexia (an inability to recognize letters and words) usually are not caused by eye conditions. However if either is a problem, your child should have an eye examination to rule out eye-coordination or vision problems.

Childhood eye problems do not resolve on their own, but most will not damage sight if treated early. Take your child to an eye doctor or to your pediatrician or family physician as soon as you spot a problem.

Your child may be afraid of an eye examination and may not cooperate. You can help by telling your child what to expect:

• There will not be any injections.
• The doctor asks you to name pictures or letters or point to things. You may wear special glasses or sit at a big machine.
• The doctor may put drops in your eyes. The drops may sting for a few seconds, and your vision may get a little blurry, but this will go away shortly.
• The doctor shines a light in your eyes to see inside them.

• Pay attention to your child’s eyes and behavior.
• Call the doctor if you notice a problem or if your child complains.
• Have your child’s eyes checked at six months, three years, five years, and at least once between the ages of seven and eighteen.
• Correcting vision problems early is the best way to protect your child’s eyesight.