Eye problems that can affect children

• Most eye problems in children can be easily diagnosed and managed with glasses, eye drops, or other simple treatments when identified early. 
• If you notice any changes in your child’s eyes or vision, it’s best to have them checked by an eye care professional.
• Regular eye exams are important, even if no symptoms are noticed, as some problems can develop gradually without obvious signs.

Refractive error refers to how accurately the eye bends and focuses light to form a clear image of the environment. When this process is imperfect, vision becomes blurred because light rays are not focussed precisely within the eye – like a camera that is out of focus.

There are three main types of refractive error:

1. Myopia (near-sightedness): near vision is clear, but distant objects appear blurry.
2. Hyperopia (far-sightedness): distant vision is clear, but near objects may appear blurred or cause strain.
3. Astigmatism: the eye’s surface is irregularly shaped, causing blurred or distorted vision at all distances.

Children with uncorrected refractive error can show signs of vision difficulties such as squinting, sitting close to screens, or complain of blurry vision, particularly during school work or intensive concentration. Sometimes these signs are subtle, especially if one eye is affected more than the other, as the stronger eye can compensate.

Refractive errors are common in people of all ages, and is the leading cause of vision impairment and blindness worldwide.¹ They can be corrected with prescription glasses, contact lenses, or surgery.

Strabismus (often called an eye turn or squint) refers to a condition where both eyes do not look in the same direction at the same time. It occurs when the muscles that control eye position are not aligned properly, preventing the eyes from pointing in the same direction.

The most obvious sign of strabismus is a visibly turned eye, which may or may not be constant. Children may also shut one eye or even tilt their head in order to see more clearly. Depth perception and coordination can be affected by strabismus.

The two most common forms of strabismus are:

1. Accommodative esotropia: the eyes to turn inward due to the extra focusing effort needed to keep vision clear while viewing up close.⁴
2. Intermittent exotropia: the eye muscles have difficulty keeping both eyes straight, leading to one eye drifting outward occasionally – particularly when the child is tired or looking into the distance.⁵

When the eyes are misaligned, the brain receives two different images – one from each eye. To avoid double vision, it may start ignoring the image from one eye – a process that can lead to reduced vision in that eye, known as amblyopia or ‘lazy eye’. 

Strabismus most often develops in infancy or early childhood and does not usually resolve on its own without treatment. Depending on the cause and type, treatment may include glasses, vision therapy, or in some cases re-alignment surgery. 

Binocular vision disorders refer to a set of eye muscle coordination problems that occur when the muscles responsible for eye movement of focussing don’t work together properly. 

Children with binocular vision disorders may seem to have perfectly clear eyesight but still struggle with near tasks.

The eyes use two types of coordination systems to focus accurately:

1. Convergence: when the eyes turn slightly inwards in order to look at something close, such as a pen.
2. Accommodation: when the eyes increase their focussing effort to see near objects clearly.

If either system is overactive, underactive, or poorly coordinated, the eyes can struggle to maintain focus. These may cause discomfort, headaches, eye strain, or difficulty concentrating during tasks such as screen time and close work.

Binocular vision disorders can usually be managed with prescription glasses or vision therapy prescribed by an optometrist.

Managing binocular vision issues early can make reading and other schoolwork more comfortable and less frustrating for children.

Conjunctivitis, sometimes called ‘pink eye’, is inflammation of the conjunctiva – the thin, transparent tissue covering the white part of the eye and the inner surface of the eyelids. It is common in children, and can have several different causes.

This type usually presents with red, watery, and itchy eyes, occasionally with white, stringy mucous at the inner corner of the eye. It is commonly triggered by allergens such as dust, pet dander, or pollen.

Symptoms are often seasonal and may occur alongside hayfever-like reactions, including sneezing and a runny nose. Treatment typically involves anti-allergy or lubricating eye drops prescribed by an optometrist or doctor.

Bacterial infection of the conjunctiva can occur when a child touches their eyes with unclean hands. Signs include red eyes, yellow or green discharge, swollen eyelids, and crusting around the lashes. The eyes may feel sore and sensitive to light. 

This form can be contagious and requires assessment and treatment by optometrist or eye doctor.

Caused by viruses such as those responsible for the common cold viral conjunctivitis leads to redness, watering, irritation, and sometimes blurred vision. It may also occur alongside or after fever, sore throat, or fatigue. Most cases resolve on its own within 1-2 weeks. 

If symptoms are severe or cause significant discomfort, an optometrist can provide advice to relieve symptoms.

1. Naidoo KS, Leasher J, Bourne RR, Flaxman SR, Jonas JB, Keeffe J, et al. Global vision impairment and blindness due to uncorrected refractive error, 1990-2010. Optom Vis Sci. 2016 Mar;93(3):227–34.
2. Hou W, Norton TT, Hyman L, Gwiazda J, COMET Group. Axial elongation in myopic children and its association with myopia progression in the correction of myopia evaluation trial. Eye Contact Lens. 2018 July;44(4):248–59.
3. Tideman JWL, Snabel MCC, Tedja MS, van Rijn GA, Wong KT, Kuijpers RWAM, et al. Association of axial length with risk of uncorrectable visual impairment for Europeans with myopia. JAMA Ophthalmol. 2016 Dec 1;134(12):1355–63.
4. Coats DK, Avilla CW, Paysse EA, Sprunger DT, Steinkuller PG, Somaiya M. Early-onset refractive accommodative esotropia. J AAPOS. 1998 Oct;2(5):275–8.
5. Kaur K, Gurnani B. Intermittent exotropia. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.