Children’s Eye Care
Children’s sight develops until around the age of eight, which makes early assessment important.
Overview
Children very rarely say that they cannot see. A child with one weaker eye sees perfectly well through the other, and has no reason to think anything is wrong. A lazy eye is therefore usually found at a routine check rather than noticed at home.
The visual pathway only responds to treatment while it is still developing. Found before school age, a lazy eye can usually be corrected completely; found at ten, often it cannot. Examinations are built around that window, and carried out at a pace that keeps a child relaxed.
When to seek assessment
- An eye that turns in, out or drifts, particularly when tired
- Sitting close to screens, screwing up the eyes, or tilting the head
- Rubbing one eye, or closing one eye in bright sunlight
- Reluctance to read, or losing their place while reading
- A white or unusual reflection in flash photographs — please seek assessment promptly
- A family history of squint, lazy eye or a strong prescription
Diagnosis
How the assessment is made
Age-appropriate vision testing
Tests chosen for your child’s stage of development rather than their birthday, so that even a very young child can be assessed reliably.
Prescription measured with drops
Drops that briefly relax focusing reveal a child’s true prescription. Without them a child’s own focusing power can hide a significant long-sighted prescription completely.
Eye alignment and 3-D vision
Careful measurement of any squint and of how well the two eyes work together to give depth perception.
Examination of the back of the eye
A look at the optic nerve and retina to rule out any structural cause of reduced vision.
Treatment
Options and what each one is for
Glasses
An accurate prescription alone resolves a proportion of squints and much reduced vision, and is always the first step.
Treating a lazy eye
Patching or drops used on a supervised schedule, with realistic targets and progress measured at every visit rather than assumed.
Slowing short-sightedness
Low-dose drops, specially designed spectacle lenses and overnight lenses that slow how quickly short-sightedness increases — reducing lifelong risk to the retina, not merely the thickness of a lens.
Squint management
Exercises, prisms, botulinum toxin or surgery to align the eyes, coordinated with paediatric colleagues where that is appropriate.
Recovery
What to expect afterwards
After the visit
Dilating drops blur near vision and make children sensitive to light for up to a day. Sunglasses and a quiet afternoon help.
During treatment
Patching progress is reviewed every six to twelve weeks. Consistency at home is the main thing that decides the outcome.
Follow-up
Yearly review through the school years, and every six months where short-sightedness is increasing or a lazy eye is being treated.
Questions
Frequently asked
If your question is not answered here, it is welcome in consultation — or by message before you book.
Between three and four years of age, and sooner if there is a family history of squint or a strong prescription, or if anything has been noticed at home.