Signs that indicate eye problems in children

• Subtle changes in how a child interacts with their environment, like squinting, sitting too close to screens, or rubbing the eyes, can suggest vision-related difficulties.
• Physical changes such as red eyes, a white pupil, or one eye turning in or out may indicate an underlying eye disease or health concern that requires further assessment.
• Not all signs mean something is wrong, but when changes persist or seem unusual, any uncertainty should prompt a comprehensive eye examination.

Squinting when looking at distant or detailed objects can occur when both eyes are struggling to form a clear image. 

Squinting is a natural response to seeing bright lights and also a mechanism for the eye to bring blurred objects into focus. By narrowing the eyelids, less scattered light enters the eye, allowing blurred objects to temporarily appear sharper.

Closing one eye can help to see objects more clearly when the two eyes aren’t working well together. 

By relying on the clearer eye (and covering the other), a child can momentarily reduce double or blurry vision.   

Children who move closer to see or hold objects very close to their face may be compensating for blurred vision. 

Parents or teachers may notice that the child is complaining of difficulty seeing the board at school from the back of the classroom, or bringing the computer screen closer to read.

When a child moves closer to an object, it appears more magnified to the eye, making it easier to see. Getting closer can temporarily help children recognize shapes or letters that might otherwise look small or blurry from a distance.

Occasional eye rubbing can be quite normal, but persistent eye rubbing can point to underlying issues.

The most common cause of excessive eye rubbing is irritation caused by allergies (e.g. allergic conjunctivitis), which is common in children who experience hayfever and allergies to dust or pets. 

Allergic eye problems such as allergic conjunctivitis are usually accompanied by other signs such as red, watery, or itchy eyes; and can usually be treated with over-the-counter or prescription eye drops.

Children might rub their eyes due to foreign bodies, like a speck of dust trapped under the eyelid. Excessive eye rubbing can also be associated with other issues such as uncorrected vision, eyestrain, and dry eyes – particularly during tasks that require more focus or concentration.

Learning to read and write is difficult – it’s common for younger children to mix some letters up or reverse some letters. But when reading or close tasks cause discomfort, a child may avoid them altogether. 

Symptoms of eye discomfort during near work can suggest underlying issues like uncorrected vision or problems with the coordination of eye muscles (binocular vision).¹ These include headaches, sore eyes, and blurry vision.

Redness and watering are common signs of eye irritation and can occur for variety of reasons. 

Mild redness is common and can be triggered by eye rubbing and eye strain after a long period of concentration. In these instances, the redness often resolves without the need for medications or eyedrops within a few hours.

If a red eye appears to be persistent, getting worse, or is accompanied by pain, swelling, or light sensitivity, it can be a sign of eye inflammation or infection. Should this be the case, it is best to consult an optometrist or eye care practitioner for assessment and further advice.

In ordinary circumstances, the pupil normally appears black. When a bright light is shone towards the eye (e.g. flash photography), the pupil will appear to be orange-red, due to the reflection of light from within eye. This is known as the ‘red reflex’. 

However, a white pupil (leukocoria) is considered highly abnormal, especially if seen consistently in only one eye and in photos taken with flash. 

When one eye appears to drift inward, outward, up, or down, it may indicate an eye condition called strabismus, sometimes referred to as an eye turn or squint. 

An eye turn is caused when the muscles that control eye movement do not align the eyes correctly to point in the same direction.

Eye turns interfere with various aspects of eye coordination (binocular vision) and over time, may lead to amblyopia (also known as ‘lazy eye’) and reduced vision, and impaired depth perception. 

Some eye turns can be intermittent, only occurring when the eyes are distracted or fatigued. Eye turns which develop suddenly or become constant should be investigated promptly. 

Regular eye examinations are an important part of every child’s health routine, even when no obvious problems are noticed. 

Most vision conditions can easily be managed with prescription glasses or contact lenses and/or eye exercises. 

On the other hand, signs or symptoms of eye health problems should be addressed promptly before they potentially escalate.

If you notice any or the signs or symptoms described above, it is best for a child get assessed through a comprehensive eye examination with an optometrist or eye doctor.

1. Duckman, R. H. (2006). Visual Development, Diagnosis, and Treatment of the Pediatric Patient. Philadelphia: Wolters Kluwer Health.