Children with normal vision can see things clearly.
The lenses of their eyes change shape to focus on objects. They change
to different shapes depending on how close or far away objects are.
Children with refractive error do not have normal vision. They may not
be able to see things that are far away (nearsighted) or see things that
that are close (farsighted).
What causes refractive error?
In children with refractive error, the lens of the eye does not bend
the right way. Images are blurred instead of clear.
How is refractive error treated?
Children should have regular eye check-ups to have their vision tested.
If a child has refractive error, there are a few choices for treatment.
Contact lenses can sometimes correct vision.
Some patients wear eyeglasses instead of contact lenses.
The choice between contact lenses and glasses is usually left to the
patient.
Some patients have eye surgery or laser treatment to correct their vision.
The doctor will give you specific information on the treatment that
is right for your child.
Cross-Eyes (Strabismus)
How should the eyes work?
It is normal for newborn babies to have eyes that sometimes look in
different directions, especially if they are tired.
If your child's eyes cross or wander after he is 3 months old, call
your doctor.
Children with normal vision use both eyes to look in the same direction
at the same time.
What causes cross-eyes?
The condition of being cross-eyed is also called strabismus.
Children who are cross-eyed get a different picture from each eye.
The strong eye can see better than the weaker eye.
The child's brain ignores the picture from the weaker eye.
How are cross-eyes treated?
Children should have regular eye check-ups to have their vision tested.
If cross-eyes are not treated, your child's brain will not use his weaker
eye. This usually leads to lazy eye, described in the section below.
Treatment works best if it is started early.
The goal is to make the weak eye stronger.
If a child has cross-eyes, there are a few choices for treatment.
The most common treatment is wearing an eye patch over one eye. When
the eye that sees best is covered, the brain will use the weak eye to
see. This helps make the weak eye stronger.
Instead of using an eye patch, some doctors use eye drops to blur vision
in the strong eye. This has the same results as using the patch.
In some cases, the problem can be corrected by wearing eyeglasses or
contact lenses.
Some patients can do eye muscle exercises to make the weak eye stronger.
Treatment can last many months or even a few years.
After treatment to make the weak eye stronger, some patients still need
eye surgery.
Lazy Eyes/Wandering Eyes (Amblyopia)
How should the eyes work?
A child with normal vision has two strong eyes. Both eyes see clearly.
The brain uses both eyes for visual information.
What causes lazy eye?
Lazy eye is also called amblyopia.
Children usually begin to get lazy eye between birth and the time they
are 6-9 years old.
A child with lazy eye has different vision in the left and right eye.
One eye (the stronger one) can see better than the other (the weaker one).
The brain starts using the stronger eye and ignores the weak eye. If
the weaker eye is never used, its vision will not improve.
Lazy eye can be caused by a refractive disorder or cross-eyes (discussed
in the sections above). These conditions could cause the child to use
one eye more than the other.
Children with lazy eye may squint, look cross-eyed, or tilt their head
to see things.
Sometimes it looks like the eye wanders in different directions at different
times.
How is lazy eye treated?
Children should have regular eye check-ups to have their vision tested.
If lazy eye is not treated, the weaker eye's vision may never improve
and it may even become blind.
Treatment should begin as soon as possible.
If a child has lazy eye, there are a few choices for treatment.
The most common treatment is wearing an eye patch over one eye. When
the eye that sees best is covered, the brain will use the weak eye to
see. This makes the weak eye stronger.
Instead of using an eye patch, some doctors use eye drops to blur vision
in the strong eye. This has the same results as using the patch.
In some cases, the problem can be corrected by wearing eyeglasses or
contact lenses.
Some patients can do eye muscle exercises to make the weak eye stronger.
Other patients need eye surgery.
When should I call the doctor?
Call your pediatrician or an eye doctor if your child seems cross-eyed.
Call if your child holds his head in a strange position when he is looking
at something far away.
Call if your child squints a lot.
Call if your child closes or covers one eye to look at things.
Call if your baby always turns his head to one side to look at you.
Call if your baby has cross-eyes after he is 3 months old.
Call if your child's teacher notices vision problems at school or if a school
nurse reports his eye exam was not normal.
Call if you have questions or concerns about your child's condition.
Quick Answers
Children with normal vision use both eyes to focus on an image. Both eyes
look in the same direction at the same time. The eyes adjust to how far away
the object is.
Children with vision problems may be nearsighted or farsighted. Some children
have one eye that is stronger than the other. The strong eye can see better
than the weaker eye. This difference can lead to lazy eye or cross-eyes.
The goal of treatment is to help the person see objects that are both far
away or near. Treatment for other children aims to make their weak eye stronger.
Call the doctor if your child squints a lot, tilts his head to look at things,
appears cross-eyed after 3 months old, or covers or closes one eye to look
at things.
References
American Academy of Family Physicians. Strabismus (Cross-Eyes). FamilyDoctor.org.
2000 January (cited 2001 November 29). Available from: URL: http://familydoctor.org/handouts/309.html
American Optometric Association. Answers to Your Questions About Crossed-Eyes.
1997 (cited 20 December 2001).
InteliHealth. Lazy Eye (Amblyopia). 2001 April 16 (cited 2001 November 29).
Available from: URL: http://www.intelihealth.com/IH/ihtIH?t=9442&p=-br,IHWI-st,4081-r,WSIHW0001-b,*|
The Merck Manual Home Edition. Refractive Disorders. 1995-2001 (cited 2001
November 29). Available from: URL: http://www.merck.com/pubs/mmanual_home/sec20/217.htm
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