As parents, we’re used to keeping an eye on all sorts of things when it comes to our children’s health and development. We notice when they start crawling, walking, talking and reading. We keep an eye on their teeth, hearing, growth and general wellbeing.

But what about their eyesight?

Children’s eye health can be easy to overlook, particularly because many children don’t realise they have a problem with their vision. If they have always seen the world in a certain way, they may simply assume that everyone sees things as they do.

That’s why regular children’s eye tests are so important – and why you don’t necessarily need to wait until your child tells you they can’t see properly.

We spoke to Dr Nigel Best, an optometrist with around 30 years of experience and Head of the Professional Services Team at Specsavers, to explore everything parents need to know about children’s eye health.



When should a child have their first eye test?

If you have concerns about your child’s vision, you should arrange an eye examination regardless of their age. Your optometrist can assess whether they are able to carry out the examination or refer you to someone who can.

But even if you have no concerns at all, it is a good idea for children to have an eye test at around three or four years old, ideally before they start school.

This is because some vision problems can be present without any obvious symptoms. Your child may not complain about their eyesight simply because they don’t know that what they are seeing is different from everyone else.

It’s a little bit like having a child who has never tasted chocolate and asking them if they like chocolate. They have no point of reference!

The same can be true of vision. A child with a problem affecting one eye, for example, may not notice because their other eye is working perfectly well.

 

Why is early detection of children's eye problems important?

Children’s vision continues to develop during the early years of life, with a particularly important period up to around the age of eight.

This means that identifying and treating certain eye problems early can make a significant difference. Some conditions, including lazy eye, can be much more difficult to treat once a child is older.

One of the reasons optometrists recommend eye examinations before children start school is to identify problems that might otherwise go unnoticed. A child may be happily getting on with life, playing, reading and learning, without ever realising that their vision could be better.

And, as parents, we can’t always spot a problem either.

 

What are the most common eye problems in children?

There are lots of different eye conditions and vision problems, but some of the terms you may hear most often include long-sightedness, short-sightedness, squints, lazy eye and astigmatism.


Long-sightedness in children

Most young children have a small amount of long-sightedness, which often does not need treatment and can naturally reduce as they grow.

However, a significant amount of long-sightedness can affect a child’s ability to see things up close. This may make activities such as reading, writing or completing close-up tasks more difficult.

You may notice that your child:

  • Struggles with reading or writing
  • Has handwriting that is noticeably poorer than expected
  • Finds some close-up activities difficult
  • Struggles with tasks that require good visual coordination

Long-sightedness is also associated with an increased risk of developing a squint or lazy eye, which is why identifying it early can be so important.


Short-sightedness in children

Short-sightedness, also known as myopia, means that a child can see things close up but has difficulty seeing things in the distance.

It often becomes more noticeable in older children, particularly around the age of nine, 10 or 11 and onwards.

You might notice your child:

  • Struggling to see the whiteboard at school
  • Moving closer to the television
  • Complaining that things in the distance look blurry
  • Being moved to sit nearer the front of the classroom

Short-sightedness is becoming increasingly common, and optometrists are now able to offer specialist glasses and contact lenses designed to help slow its progression in some children.


What is a squint?

A squint is when the eyes do not point in exactly the same direction. One eye may turn inwards, usually towards the nose.

Squints can sometimes come and go, particularly when a child is tired or has been concentrating on something for a long time. This means you might notice something that your optometrist does not see immediately during an appointment.

If you think your child has a squint, it is important to arrange an eye examination. Even if the eye looks straight most of the time, your concerns are worth investigating.

A photograph can also sometimes be useful if you notice a squint that is not present all the time.


What is a lazy eye?

A lazy eye, or amblyopia, occurs when the vision in one eye has not developed properly.

The eye itself may be healthy, but the connection between the eye and the part of the brain responsible for vision has not developed as it should.

A lazy eye can be caused by a squint or by a significant difference in prescription between the two eyes.

One of the challenges is that a child may not realise there is a problem. If one eye sees very well, they may be perfectly happy with their vision, even if the other eye is not working as well.

This is another reason why early eye examinations are so important. Treatment is generally more effective while a child’s visual system is still developing.


What is astigmatism?

Astigmatism is a very common type of refractive error. It is not a disease and is nothing to be worried about.

The front surface of the eye, called the cornea, is ideally perfectly round. In people with astigmatism, it is shaped slightly more like a rugby ball than a football. This means the eye has different focusing powers in different directions.

Astigmatism often occurs alongside short-sightedness or long-sightedness and can usually be corrected with glasses or contact lenses.

What happens during a children’s eye test?

You might be wondering how an optometrist can test a young child who cannot yet read or recognise letters.

The good news is that children do not need to be able to read to have their eyes tested.

Optometrists use a combination of objective and subjective tests. With younger children, objective tests are particularly useful because they do not require the child to give complicated answers.

They may use lights, special equipment and pictures to assess the child’s eyes and vision.

For example, a child might be shown pictures of a car, a boat or a house and asked to point to the matching picture on a card. The images are specially designed so that the optometrist can accurately assess how well the child can see.

Some children may also be given special glasses to test depth perception.

And if your child is feeling nervous, they can often sit on your lap during the examination. They don’t need to be able to answer every question perfectly, and they certainly don’t need to be able to read.

Every child is different, so the examination will be adapted to their age and ability.

 

How often should children have their eyes tested?

The frequency of eye tests depends on your child’s individual circumstances.

If a child has a significant prescription or a condition requiring treatment, they may need to be seen more regularly – perhaps every few months initially.

For a child with normal vision and no concerns, a routine eye test every couple of years may be appropriate.

Children who are short-sighted may need more frequent checks because their prescription can change as they grow.

As always, if you notice a change in your child’s vision or have any concerns, don’t wait for the next routine appointment. Contact your optometrist.

 

Are children’s eye tests free?

In the UK, children under 16 are entitled to an NHS-funded eye examination. This entitlement can continue until the age of 18 if they remain in full-time education.

If your child needs glasses, an NHS optical voucher may also contribute towards the cost and, depending on the prescription and frames chosen, may cover the full cost.

So if you have been putting off arranging an eye test because you are worried about the cost, it is worth checking your child’s eligibility.

 

What should you do about conjunctivitis, styes and minor eye problems?

If your child has a minor eye condition, such as a red or sore eye, conjunctivitis or a stye, your local optometrist may now be the best first port of call.

Across much of the UK, locally commissioned services mean that optometrists can assess and advise on many minor eye conditions, often without a charge to the parent.

Optometrists have specialist equipment designed specifically for examining the eyes, and many are also qualified to prescribe certain treatments.

If you are unsure whether your child needs an eye test or an eye health check, contact your local optometry practice for advice.

 

What if something gets into my child’s eye?

If your child gets something small in their eye and has mild discomfort or redness, your local optometrist may be able to examine the eye and remove a foreign body.

However, if the eye is extremely painful, there has been a significant injury or you suspect something has become embedded in the eye, you should seek urgent medical attention, such as through an eye casualty service or A&E.

For serious eye injuries, particularly those involving metal or high-speed objects, it is important to seek urgent medical advice.

 

Does screen time damage children’s eyes?

This is a question many parents will be very familiar with!

While short-sightedness is becoming increasingly common, the evidence that screen time itself directly causes short-sightedness is not strong enough to say that screens are the cause.

However, there is strong evidence linking more time spent outdoors with a lower risk of developing short-sightedness or slower progression of myopia.

So rather than feeling guilty every time your child picks up a tablet, think about the bigger picture. Encouraging children to spend regular time outdoors is good for their general health and may also benefit their eye health.

And yes, we know that getting children off screens and outside can sometimes feel like an Olympic sport in itself!

 

The most important thing to remember about children’s eye health

The biggest takeaway is simple: don’t assume that your child’s vision is fine just because they have not complained about it.

Children may not know that they have a problem with their eyesight, particularly if it has been present for a long time.

Arranging an eye examination before your child starts school – ideally around the age of three or four – can help identify potential problems early, when treatment may be more effective.

So, if your child has never had an eye test, why not add it to your to-do list?

It might be one of those appointments that you never knew you needed – and your child might even come away with a pair of glasses they think are incredibly cool!

After all, as parents, we spend so much time looking after our children’s health. Their eyesight deserves a place on that list too.

 

Book your child’s eye test here: https://www.specsavers.co.uk/eye-test/childrens-eye-test

You can listen to this episode of the Family Health by Mini First Aid podcast with Nigel, available on all major platforms including Apple Podcasts and Spotify, or watch on YouTube.


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