Health Issues

Middle childhood is a common time for the recognition of vision problems, especially when children first have assigned seats in classrooms. Your child may tell you that he cannot read the blackboard unless he squints or moves to a front-row seat. Or you may notice that when he watches television, he sits close to the set. Less commonly, your child may complain that the words on the pages of books are blurry. All of these suggest a focusing prob­lem and call for an examination by an eye doctor.

Myopia, or nearsightedness, is the most common vision problem among school-age children, often developing between age six and adolescence. With this condition the eyeball has an elongated shape, and thus light passing through the lens of the eye is focused in front of the retina rather than on it. As a result the child cannot clearly see distant objects.

Children with hyperopia, or farsighted­ness, have the opposite problem. Because of the shorter shape of their eyeballs, im­ages are focused behind the retina, causing them to be blurry. These children cannot clearly see objects that are close to them without making an effort to focus, although this effort may not be a conscious one.

Both of these conditions can be inherited. Myopia and hyperopia may require eyeglasses to correct the poor vision. Most doctors recommend that active children wear shatter-resistant plastic lenses to minimize the chances of serious accidents. Some children prefer contact lenses, but because the lenses require diligent care, doctors often discourage their use prior to adolescence. Laser surgery to correct my­opia is not done until adulthood, when the eye has finished growing.

Some children also have an astigmatism, in which the front of the eye is shaped more like a football than a basketball. As a result, the vision may be similar to that seen when looking in a mirror with a wavy surface, like a fun-house mirror that makes you seem too tall, too wide, or too thin. Astigmatism is usually inherited, may be present at birth, and may remain little changed throughout life. Normally, the blur from astigmatism is corrected with glasses or contact lenses. Small amounts of astig­matism are common and do not require correction.

Here are some other points to remember about your child's vision:

  • Even though visual difficulties can sometimes cause headaches, this pain is most often associated with prob­lems unrelated to the eyes.
  • If your child wears glasses and partici­pates in competitive sports, the glasses should be secured in place by attaching a strap that connects the two earpieces and stretches behind the head. Also, special sports glasses are available.
  • Some optometrists recommend eye ex­ercises to help treat learning disorders like dyslexia. However, carefully controlled studies have failed to demon­strate any benefits from these eye exercises—or from wearing colored lenses—to treat these disorders.


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Caring for Your School-Age Child: Ages 5 to 12 (Copyright © 2004 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.