Good vision is critical in a child's education, social growth and overall development. Vision tests in school may not detect all vision problems. It is important for your child to have an eye exam before age 4 and periodically thereafter to detect vision problems that may go unnoticed. Strabismus, amblyopia and refractive errors are common vision problems in children. Big words, with treatable solutions, early detection is key.

Strabismus is a visual defect in which the eyes are misaligned and point in different directions. The exact cause of strabismus is not fully understood.  Strabismus may be seen alone or with other disorders of the eye (e.g. cataract or eye injury) or with disorders of the brain (e.g. brain tumors, cerebral palsy, Down syndrome).  With normal vision, both eyes aim at the same spot and the brain fuses the two pictures into a single three-dimensional image.  When one eye turns, two different pictures are sent to the brain.  The brain learns to ignore the misaligned eye and sees only the image from the straight, better-seeing eye. The child then loses depth perception.  Untreated strabismus often leads to amblyopia.

If there is a family history of strabismus or amblyopia, children should have an eye examination at or before their fourth birthday. Treatment of strabismus may include eyeglasses, eye exercises or surgery on the eye muscles.  Glasses may still be required after the surgery. 

Amblyopia is poor vision in an eye that did not develop normal sight during early childhood. It is sometimes called "lazy eye." There are three major causes of amblyopia: strabismus (misaligned eyes); refractive error (unequal eyes); and, occlusion (cloudiness in the normally clear eye tissues).

Amblyopia cannot be cured by treating the cause alone. The weaker eye must be made stronger in order to see normally. A common treatment is to patch or dilate the strong eye; the weak eye is strengthened because the child is forced to use it.  Studies show that after the age of 8, if the weak eye isn’t strengthened, the brain will shunt its activity elsewhere and the eye will not see better.  There is no cure for amblyopia.  It is imperative that children be examined and treated as soon as possible.

A learning disability is a disorder in understanding or using spoken or written language. Individuals with learning disabilities have average to above average intelligence, but experience problems with reading, writing, listening, speaking, concentration, and mathematical calculations. 

Dyslexia is a type of learning disability that involves reading difficulties.

A child with a learning disability needs to practice academic skills and learn helpful strategies with the aid of a trained specialist.  No scientific evidence has shown that visual training, muscle, perceptual or hand/eye coordination exercises can improve a child’s learning disability. 

The importance of vision care begins in early childhood; set your child up for success in life with proper attention to eye health.

Guest blogger NOMS Ophthalmologist, Dr. Kristina Pao.  


Kristina Pao, MD