The wonders of the world are often seen through the eyes of a child. Yet without good vision, a child's ability to learn about the world is lessened. Vision problems affect one in twenty preschoolers and one in four school age children.

Since many vision problems begin at early ages, it is very important that children receive proper eye care. Untreated eye problems can worsen and lead to serious problems as well as affect learning ability, personality, and his or her adjustment in school.

Development of Vision

During Pregnancy. Visual development begins as early as the fourth week of pregnancy. At this time, the beginnings of the eye are smaller than the head of a pin and are hidden under a layer of skin. In the next few months, the eyes' nerves and blood vessels start to grow, as do the lens and the retina. At the end of the sixth month of pregnancy, the eye has completed much of its physical development.

Newborns. The acuity (sharpness of vision) of newborns is less than fully developed. They usually prefer looking at close objects and are especially attracted by faces and by objects that are brightly colored or moving.

Three Months. By this age, most babies can smoothly follow a moving object and can hold their eyes on it even when it stops. The colors, details and moving parts of mobiles in cribs fascinate infants and helps to stimulate their visual development.

Three to Six Months. By now the retina of the eye is quite well developed and the baby's visual acuity is good enough to permit small details to be seen. The infant is able to look from near to far and back to near again. Judgment of distances (depth perception) is also developing.

Six Months. At six months of age, the eye has reached about two-thirds of its adult size. Usually by this stage the two eyes are fully working together resulting in good binocular vision. Distance and depth perception are still improving.

One Year Old. By the age of one, a child's vision is well on its way toward full development. Coordination of the eyes with the hands and body are naturally practiced by children, and can be enhanced by games involving pointing, grasping, tossing, placing and catching.

Two to Five Years Old. The preschooler is typically eager to draw and look at pictures. Stories connected to pictures, drawings and symbols often captivate the child and help to coordinate hearing and vision.

Children's Eye Problems

Just because your child doesn't complain about his eyesight, you can't assume that there aren't any vision problems. Most children believe that the way they see is the way everyone sees -- even if vision is blurred, double or through only one eye. Some vision problems can be suspected from a child's behavior and the appearance of the eyes. But, the best way to find out if your child's vision is normal is through regular eye exams.

Early treatment of children's vision problems is important because it can provide children with added potential to learn and develop, and because some eye conditions, if left untreated, may worsen and become more difficult to correct later.

Signs of Possible Eye Trouble

As a parent you may be somewhat relieved to know that most eye problems can and should be detected in regular exams. Here are some signs that can alert you to possible trouble in your child.

Behavior:

• Rubs eyes excessively
• Shuts or covers one eye
• Tilts head or thrusts head forward
• Has difficulty with reading or other close-up activities; holds objects close to eyes
• Blinks more than usual or is irritable when doing close-up work
• Is unable to see distant things clearly
• Squints eyelids together or frowns

Appearance:

• Crossed Eyes
• Red-rimmed, encrusted, or swollen eyelids
• Inflamed or watery eyes
• Recurring styes (infections) on eyelids

Complaints:

• Eyes itch, burn or feel scratchy
• Cannot see well
• Dizziness, headaches or nausea following close-up work
• Blurred or double vision
• If your child exhibits one or more of these signs of possible eye trouble, professional eye care should be sought. Regular eye exams are important since some eye problems have no signs or symptoms.

Some Risk Factors

It is important to note that some children are at a higher risk for developing eye problems and should be followed closely by their doctor for signs of possible eye problems. Some high risk factors include:

• Premature birth
• Family history of eye problems (cataracts, amblyopia, misaligned eyes, or eye tumors)
• Mother with health problems such as diabetes
• Eye injuries

How Infant Vision is Tested 

Most eye problems can be corrected if they are detected and treated early. Professional eye exams and treatment are essential for maintaining good vision, since untreated problems -- even for a short period -- can result in permanent vision loss. In infancy, your child's vision may be tested by your pediatrician or family physician. Later, examination by an eye care specialist is recommended. Here are some ways vision can be tested:

Home Eye Tests. These consist of an eye chart, instructions and notes on how to interpret the results. The test, conducted at home, helps parents become aware of possible eye problems and gives children practice at taking such tests.

Vision Screenings. Typically test visual acuity (sharpness of vision) and sometimes other vision functions. Such screenings, although not substitutes for professional eye exams, may detect or find warning signs of possible vision problems. In such cases, referrals are made to eye care specialists.

Professional Examinations. Usually include many tests that are directed at such things as the health of the eyes, their refractive state (farsightedness, nearsightedness, astigmatism), visual acuity, eye muscle control, coordination of both eyes and color vision. With today's technology, an assessment of a child's vision can be made even in infancy.

Types of Treatment

Many forms of treatment are available to correct eye problems. The following forms of treatment may be used alone or in combination.

• Glasses are commonly prescribed to compensate for a refractive error such as farsightedness, nearsightedness, or astigmatism, correct a focusing problem, or overcome an eye turn.
• Medication, such as drops or ointment, is used to treat infections and sometimes to treat strabismus and amblyopia.
• Patching of one eye on a temporary basis is common in the treatment of amblyopia.
• Surgery may be necessary to remove the eye lens if it has a cataract, reduce pressure within the eye if there is glaucoma, or adjust an eye muscle if strabismus is present.
• Eye exercises may be recommended to correct faulty visual habits associated with strabismus and to help the eyes work together