Q: My child is about to start grade one and I’ve noticed that she squints while watching TV. Is this a warning sign that she may need glasses?

A: Vision problems in children begin to occur mid-childhood – about the same time they begin elementary school. You may notice that your child squints or she may tell you that she has trouble focusing on the words in her textbook.

Other noticeable signs include:

  1. One eye keeps drifting out of alignment with the other.
  2. Closing one eye to see objects better.
  3. Frequent eye rubbing.
  4. Constant complaint of headaches.
  5. Tilting head.

Less noticeable signs include:

  1. Avoiding work that requires your child to be close to an object, such as reading a book.
  2. Difficulty with eye-hand coordinated activities, such as catching a ball.
  3. Sitting close to the TV.

All of these symptoms suggest a focusing problem and should be examined by an eye doctor.

A thorough eye exam includes tests for myopia (nearsightedness), hyperopia (farsightedness), astigmatism, color perception, lazy eye, crossed-eyes, eye coordination, depth perception and focusing ability. Most eye care professionals will also perform a general exam to assess the health of your child’s eyes. An eye exam can easily determine if your child has a vision condition that requires glasses.

Schools sometimes perform vision screenings, which attempt to identify, as early as possible, school age students who may have undetected vision difficulties. It is important to keep in mind that although school vision screenings are important, they do not replace a thorough eye examination.

Common Vision Problems

Myopia, or nearsightedness, is the most common vision problem among school-age children, often developing between age six and adolescence. With this condition, images are focused so they fall in front of the retina instead of right on it. Your child’s cornea may be curved too much, or the distance between the front and back of his eye may be too great, or a combination of the two. As a result, your child cannot clearly see objects that are far away.

Children with hyperopia, or farsightedness, have the opposite problem. Images are focused so they fall behind the retina instead of right on it. It could be that your child’s cornea is too flat, that the distance between the front and back of his eye is too short, or a combination of the two. Your child will be able to see objects clearly at a distance, but have trouble focusing on close up tasks like reading a book or doing their homework. In some extreme cases, a child may also experience difficulty seeing objects clearly at a distance.

Some children also have astigmatism, in which the front of the eye is elongated rather than spherical, or slightly distorted in shape, causing even more blurriness for your child. Astigmatism may be inherited, may be present at birth and may change throughout life. Small amounts of astigmatism are common and may not require correction.

Because a change in vision can occur without you or your child realizing it, you are advised to have your child’s eyes examined regularly, as recommended by your eye doctor.

Colour photo of Dr. Angela Monetta

The Expert:

Dr. Angela Monetta is a graduate of the School of Optometry at the University of Waterloo.