Children’s Eye Care

Most children have excellent sight and do not need to wear glasses.

All children should have vision screening done at state schools (between the ages of four and five). However, if there are problems and they are not picked up at an early age, the child may have permanently reduced vision in one or both eyes.

If you have any concerns about your child’s eyes, or if there is a history of squint or lazy eye in the family, do not wait for the vision screening at school. Take your child to your HV or GP to be referred to the orthoptist or to a local optometrist for a sight test. This is free under the NHS for children under 16.

Your child does not have to be able to read or talk to have a sight test.

Babies

Babies can see when they are born, but their eyes don’t always focus accurately. A baby’s eyes may squint sometimes (where the eyes are not lined up together), but if their eyes always seem to be out of alignment, this should be investigated. Their eyes develop gradually, and after about six weeks they should be able to follow something colourful or interesting with their eyes.

If they don’t seem to be able to focus on you properly. For example, if they can’t follow you and recognise your facial gestures, or if their eyes wander when they are looking at you. It could suggest a problem.

You can also try covering each of the baby’s eyes in turn. If they object to having one eye covered more than the other, they may have problems seeing out of one eye. As they get older, start to point out objects both close up and far away. If they struggle to see the objects, contact your GP or Health Visitor for advice.

Lazy eye and squint

About 2% to 3% of all children have a lazy eye, clinically known as ‘amblyopia’. This may be because they have one eye that is much more short or long-sighted than the other, or they may have a squint (where the eyes are not lined up together).

If you notice your child appears to have a squint after they are more than six months old, you should have their eyes checked as soon as possible. The sooner the child is treated, the more likely they are to have good vision. If a lazy eye is not treated before the child is aged seven or eight, the child’s vision may be permanently affected.

Which children should be tested?

You should make sure your child’s eyes are tested if:

Your child has special needs. Children with special needs often have eye problems.
There is a history of a squint or lazy eye in your child’s family.
People in the family needed to wear glasses when they were young.

Signs to look out for

One eye turns in or out. This may be easier to spot when the child is tired.
They rub their eyes a lot (except when they are tired, which is normal).
They have watery eyes.
They are clumsy or have poor hand and eye co-ordination.
Your child avoids reading, writing or drawing.
They screw up their eyes or frown when they read or watch TV.
They sit very close to the TV, or hold books or objects close to their face.
They have behaviour or concentration problems at school.
They don’t do as well as they should at school.
They complain about blurred or double vision, or they have unexplained headaches.

Don’t expect your child to tell you if there is a problem. Children assume that the way they see is normal. They will never have known anything different.

Protect your child’s eyes from the sun

There is evidence that too much exposure to the sun’s ultraviolet (UV) rays can contribute to the development of cataracts and age-related macular degeneration.

Because children tend to spend a lot of time outside, it’s important to protect your child’s eyes in the sun. Make sure your child’s sunglasses have 100% UV protection and carry the British Standard (BS EN 1836:2005) or CE mark.

You can also protect your child’s eyes by making sure they wear a hat with a brim or a sun visor in bright sunlight.

However, scientific studies have shown that children who spend time outdoors are less likely to be short-sighted, and some eye problems are linked to unhealthy lifestyles, so don’t stop your child exercising outdoors. Just make sure their eyes are properly protected.

How much do eye examinations cost?

The NHS pays for sight tests for children under 16 years old, and those aged 16 to 18 in fulltime education.

If your child needs glasses, the NHS will give you a voucher, which may cover the full cost of glasses, or you can put it towards the cost if you want more expensive glasses. You can take the voucher to any dispensing optician (person who sells prescription glasses).