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Baylor College of Medicine News

Early elementary school children should be monitored for visual problems

Being able to see clearly is a very important part of learning development. Parents and teachers of early elementary school children should watch for silent warning signs of visual problems, said a pediatric ophthalmologist from Baylor College of Medicine.

"A first, second or third grader may not always tell his or her parents that they are having trouble seeing," said Dr. Evelyn Paysse, associate professor of ophthalmology at BCM. "If the child cannot see, he or she might have a difficult time learning and keeping up with the rest of the class."

Parents and teachers should watch for certain behaviors that might indicate the child needs to have a vision screening, Paysse said.

Warning signs

Classic warning signs include:

  • Sitting close to the television
  • Holding a book close to the face while reading
  • Squinting, blinking or rubbing eyes more than normal

When is evaluation needed?

"The first step is for the child to be screened by a pediatrician or the school nurse," said Paysse, also an attending physician at Texas Children's Hospital. "The pediatrician or school nurse can determine whether or not the child passes the screen or if he or she needs a comprehensive exam with an eye care specialist."

Importance of yearly screening

It also is important for all children to have yearly visual acuity (clearness) screenings yearly beginning at age 3 to 5 years, Paysse said.

"Most schools provide these screenings," said Paysse. "Parents should check with the school system to confirm. If they are not provided, they can be set up with the child's pediatrician."

Correcting visual problems in children

If an eye care specialist determines the child has significant refractive error (near-sightedness, astigmatism, or hyperopia), glasses are typically recommended.

"After about 10-11 years of age, children can usually handle contact lenses if they want them," said Paysse. "The pediatric ophthalmologist or other eye care specialist will make the decision together with the child and parents or guardians."

Other vision problems

In addition to refractive error problems, children who have trouble reading or are excessively blinking and rubbing their eyes may have a condition called convergence insufficiency.

This condition occurs when the eyes have difficulty maintaining convergence of the eyes on a near target. "Symptoms of convergence insufficiency include visual blurring, double vision, and eye fatigue with prolonged near work," said Paysse.

The condition can be treated with glasses, eye exercises and sometimes eye muscle surgery.

Whatever the condition, eye care specialists can help find the right treatment.

"We can help children get the best education possible by keeping them healthy and comfortable in their school environment," said Paysse.