Eye Problems in Children by Dr. Shilpa Elizabeth Kuruvilla, MBBS, M.S

Your Child’s Eyes

- by Dr. Shilpa Elizabeth Kuruvilla, MBBS, M.S

There are certain eye problems that can affect children. An awareness of these problems and the need for prompt diagnosis and treatment could make the difference between blindness and sight in our children.

When should my child have an eye check-up?

Some babies would have had a routine eye check done by the doctor soon after birth, or during the immunization visits to the hospital or clinic. Any obvious eye problem such as watering or crossed eyes, a white reflex within the eyes or abnormal redness of the eyes would then be picked up and the child would be referred to an eye specialist. It is important not to ignore such advice and act promptly when referred.

If you notice anything that causes you as a parent to be concerned about your child’s eyes, do not hesitate to get it checked up as soon as possible. Symptoms of concern would be watering of the eye, redness, swelling of eyelids, poor vision or crossed eyes.

If you or your family members have a history of eye problems in early childhood, it is strongly advised that you get your child’s eyes checked as early as possible, as a lot of childhood eye problems are inherited( passed down from parent to child through genes).

Watering of the eyes

MYTH: Watering from a baby’s eyes doesn’t need treatment.

FACT: Watering from a child’s eye, especially if noticed as early as a couple of weeks after birth, could mean a blocked tear duct. Normally, a tiny tube drains the tears from our eyes into the nose. In some babies, this tube is closed, resulting in watering.  Most blocked ducts in babies can be cured by a simple massage done in the proper technique. The massage helps to open up the tube, avoiding the need for any surgical procedure.  However, if the massage is not done (or done incorrectly), the tear duct will remain blocked and will need a surgical procedure to fix it.

Poor vision

MYTH: Only old people need spectacles!

FACT: The most common cause of poor vision in childhood is refractive error, which is easily treated with spectacles. Refractive error can either be short-sight (myopia) or long-sight (hypermetropia). Typically, a child with short sight will find it difficult to see things far away (like the black board in the classroom). This is usually picked up by an observant class teacher, or during school vision screenings.  A child with long sight can get headaches and eyestrain with near work, and some even develop squint.

Although simple to treat, refractive error of any type often goes neglected and untreated. This often leads to poor academic performance and poor social development (as the child, especially a short-sighted one, tends to be an introvert and prefers staying indoors). There is a misconception among some that glasses are only for older people and they refuse to get glasses for their children. This is unfortunate, because if the proper glasses are not worn by a child who needs them, it could lead to multiple eye problems, including lazy eye, squint and a permanently poor vision. It is thus very important to get your child’s eyes checked if you notice any poor vision in them, and regularly check if the glasses they have are the right ones.

What is lazy eye?

Lazy eye (or amblyopia), is a condition where the vision of the eye is less than normal because of it not being used. This could be because the eye has a squint and is turned away, or because it needs glasses to see clearly but glasses have not been used, or there is something preventing the eye to see ( like a cataract or a drooping eyelid). A lazy eye can ideally be restored to normal vision if treated promptly, vigourously and in time.


MYTH: Crossed eyes are lucky, so they don’t need to be fixed

FACT: Squint or cross-eyes, can sometimes indicate a poor vision in the eye that has turned away. The earlier a squint is checked and treated, the better the chance of fixing it. Some types of squint can be fixed with just spectacles. Others may need the good eye to be covered, so that we force the squinting eye to be used, which will improve the vision in it. Sometimes, squint needs surgery as treatment.


MYTH: Only old people get cataracts

FACT: Cataracts (an opacification, or whitening, of the transparent lens in your eye) can develop at any stage of a person’s life; one can even be born with it! Children who develop cataracts most often have family members who had the same condition in childhood. A cataract blocks light from entering the eye, which causes blindness. This is very dangerous in a child, as it blocks the normal development of nerve connections from the eye to the brain. As this development only occurs in childhood, a neglected cataract in a child, if operated too late, will not result in normal vision in that eye. A cataract is noticed as a whitish colour in the area of the pupil (the black dot in the centre of your eye). If there is a history of childhood cataract in your family, it is good to get your child’s eyes checked as early as possible.


MYTH: Big eyes are beautiful, so there’s nothing to worry about if my baby’s eyes look too big!

FACT: Although big eyes in a baby look cute, there is a cause for concern if they are abnormally big. In a child with glaucoma, the pressure in the eye is higher than normal. This causes the eyeballs to stretch and look big. If left untreated, the pressure also causes damage to the nerve at the back of the eye, leading to blindness. If the damage is long-lasting, the vision loss is permanent. 

Eye Injuries

MYTH: Eye injuries only happen to men at work!

FACT: A large number of eye injuries occur due to accidents at home and even at school! The eye is a very sensitive and delicate organ. It can be injured by even a scratch of a finger-nail! It is important to teach children from a young age on how to play safely and how to protect their eyes. Children using sharp instruments (eg, scissors for craft work) should be supervised until they learn how to handle these instruments safely. It is good to teach them to always point sharp things downwards (in the opposite direction of their eyes)- remember that even a pencil can cause permanent damage to the eye if there is an unfortunate accident.

Children love fireworks, but they can cause terrible damage to the eyes if they are not handled properly. Children must always be supervised and made to watch from a safe distance when they are near a fireworks display. 


Dr. Shilpa Elizabeth Kuruvilla, MBBS, M.S, is a visiting Consultant at Aradhana Eye Institute. She is now doing research in Flinters Hospital at Adelaide, Australia.

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Your Child’s Eyes - by Dr. Shilpa Elizabeth Kuruvilla, MBBS, M.S There are certain eye problems that can affect children. An awareness of...