Children absorb a lot of important information through their eyes, especially during the first years of life, which is why two healthy eyes are essential for their development.
However, children perceive their environment differently to adults. Blurred vision, a lack of spatial vision or similar visual disturbances are perceived by children as ‘normal’ because they are unable to compare it with correct vision. In addition, younger children are usually unable to provide any information about their actual vision.
This is why it is extremely important, especially for younger children, to detect and treat any eye diseases and changes in vision as early as possible.
Children who may suffer from an eye disease unnoticed may experienced the following accompanying symptoms:
In the case of squint, the eyes do not look in the exact same direction, which makes perceived double vision possible. There are several forms of squint:
The earlier squint is diagnosed and treated, the better the chances of normal childhood vision development. At just three years of age, however, the success of treatment decreases considerably and, despite the treatment of a visual disturbance caused by squint, no improvement can be achieved upon entering school. As a result, vision in the affected eye remains weak.
The following eye diseases are possible in childhood:
If severe refractive error remains undetected in children (for too long), this can result in permanent weakness of vision.
Significant refractive errors in both eyes are apparent when the affected child is no longer able to recognise a wide range of objects. In addition, uncertain motor movements or impaired concentration may occur, which result from problems with vision.
Sometimes this high refractive error occurs only in one eye, accompanied by what is known as microsquint. This condition of the eye can rarely be detected by parents. Children make no complaints and do not complain of any other negative symptoms. If this eye condition remains undetected in the child, this results in permanent weak vision in the affected eye.
The earlier visual defects are detected by a paediatrician or ophthalmologist, the better the success of a treatment – especially in childhood. Since one-sided visual defects in children in particular are sometimes detected too late, it is advisable for them to have a routine (i.e. without the presence of specific symptoms) ophthalmological examination, so that this type of eye condition can also be detected and treated at an early stage in the case of any doubt.
During diagnosis, the doctor can use retinoscopy (also known as cycloplegia), which provides information on whether or not there is any defect in vision requiring treatment. It is completely painless and only requires simple optical aids and an experienced examiner.
Retinoscopy is used to determine what is known as objective refraction (the patient’s visual acuity is determined by a device) and is mainly used on children. Retinoscopy essentially uses a translucent mirror that casts an image onto the back of the eye. Before the retinoscopy, the ciliary muscle (which regulates the near- and far-accommodation of the eye) is ‘paralysed’ with a drug (the tension of the inner eye muscles is released to allow an exact measurement of the refractive error).
As the child grows older, the examination options in the ophthalmologist’s practice also become more differentiated for children. However, if there are concerns that the child’s eyes may not be healthy, or if squint or aversion to light occurs, an examination by an ophthalmologist should be carried out promptly, regardless of age.
The sooner a refractive error is corrected in children, the better their vision will be. After all, what was neglected in childhood can no longer be corrected or made up for later – in adulthood.
Most refractive errors in children therefore need to be corrected with glasses between the ages of two and three in order to avoid permanent weak vision.
Refractive errors (when a sharp image on the retina cannot be created without a suitable lens, as the incoming light rays essentially undergo refraction as they pass through the cornea and lens) are often the reason for correction by means of glasses.
There are various treatment options for squint:
As refractive error can change as a result of growth, it must be checked regularly by an ophthalmologist after diagnosis.
In principle, however, children’s eyes should be examined by an ophthalmologist at regular intervals, even if there are no obvious symptoms.
Preventative care is particularly advisable for children,
