Watch for Vision Defects

by JR
(Mumbai, India)

Vision Defect in Infancy

Childhood vision defects often go unnoticed till late. Affected children experience developmental delays. Parents’ vigilance is crucial for early diagnosis.

Vision testing by a medical professional is possible only when child is able to cooperate; earliest being at 4 years of age: While vision defects are not uncommon even in infants.

Signs that could indicate compromised vision in children are often mistaken for their peculiar behavior, shyness, learning disabilities, poor intelligence or even attention deficit hyperactive disorder.

Ability to see develops very fast in newborn babies. The visual inputs play an enormous role during early development phase by contributing to:

1. Parent child bonding with ability to recognize the face.

2. Emotional and social development by correlating facial expressions to the events.

3. Consolability: Babies with vision defect are difficult to console.

4. Language development by correlating lip movements with the sound and implication of the words heard.

5. Hand - eye coordination is crucial for optimal development of motor skills.

Signs of vision defects in children

Blurry vision, stinging eyes, headaches and eye strain are the usual symptoms of vision defects. But kids are often unable to communicate their problems effectively.

In most situations, children adapt to the prevalent limitations - also the limitations of the vision that they experience! Parents, teachers and all who are involved in child care need to mark the subtle warning signs of vision defects in children.

Unusual eye movements:

Unusual eye movements are most commonly seen in children with "crossed eyes": Medically known as strabismus. This is the commonest form of vision defect; occurring in about 4% of children below 6 years of age. In some cases, it can even develop due to excessive eye strain anytime during growing years.

Most of the affected children suffer considerable psycho social embarrassments; and up to half of them develop significant permanent vision defects. Its early detection and treatment is crucial to prevent permanent visual impairment.

Parents Caution!!!
Given below could all be signs of a genuine vision defect in children.

1. Early signs of crossed eyes
Squinting, blinking too frequently, or closing one eye to get a better visual conception of the words/object under focus.

2. Change of position of self or the object
Children often change their position to have a clear vision of the object. Consequently, they are often perceived as inattentive, fidgety, or hyperactive. When asked why they change places, the innocent answer that comes is, "trying to look", which is again taken as a lie by most adults!

3. Holding the books to close:
Children with compromised vision often make grimaces while reading and writing. They close one eye, lean over the books or tilt their head to focus the words, which is interpreted as behavior disorder rather than visual defect.

4. Difficulty in getting back to where they are reading.
You will find that most of these children keep their finger glued to the book to follow along as they read/write.

5. Eye irritation:
Some children may be able to express that their eyes hurt, burn, are itchy, they are seeing things double or are unable to see the words clearly.

But, sadly enough, this is also taken as child's excuse to escape studies.

6. Temper tantrums:
Inability to cope with the rising social and cognitive demands, children with vision defects often become temperamental. Their limitations in communication competence leads to frustration and temper tantrums.

7. School related difficulties:
Poor handwriting, reversed or skipped words and too many spelling mistakes (especially when a child can say the spellings correctly but writes them wrongly) indicate underlying vision defect. They may even have trouble copying things from book/blackboard.

8. Clumsy behavior: An outward expression of an underlying vision defect
Children who are often bumping into things and dropping stuff; and seems genuinely confused, in contrast to a naughty triumphant who does it on purpose, could be victim of poor hand-eye coordination, impaired peripheral vision or defective depth perception secondary to vision defect

A simple test to evaluate this is to play with your clumsy child; and observe if she can reach for the ball effectively. Children with visual defect will miss the ball too often or reach for it far beyond its actual placement.

Color vision defect:

Parents are often concerned about their child's ability to recognize the colors; especially when they notice that their child seems to be slow in learning colors. It should be reassuring to know that "color vision deficient" children do not misname colors.

Color vision testing is usually not necessary in young children.
True "color blindness" is very rare and not compatible with normal vision. If present, it is associated with diminished visual acuity, nystagmus, and photophobia. Defective color vision is common in boys but is rare in girls.

However, if there is a noticeable change in color discrimination, then it calls for immediate medical attention.

Recommendations:

1. For early diagnosis and treatment visit your doctor if you notice any of the above signs in your child. Earlier treatment of visual defects minimizes long term adverse impact on child's development, scholastic achievements and psychosocial well being.

2. All children should have vision evaluation at age of 4, 6 and 8.

3. Between 10 and 20 years of age yearly vision check up for early diagnosis of myopia (shortsightedness)

4. Are there unanswered concerns?
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