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This post is in partnership with Ann & Robert H. Lurie Children’s Hospital of Chicago but all of the opinions within are those of The Everymom editorial board. We only recommend products we genuinely love.

Is Your Child Squinting? Common Symptoms That Indicate Your Child Needs an Eye Exam

written by ASHLEY SELLEKE, RN

This post is in partnership with Ann & Robert H. Lurie Children’s Hospital of Chicago but all of the opinions within are those of The Everymom editorial board. We only recommend products we genuinely love.

Provided by: Lurie Children's Hospital of Chicago
Provided by: Lurie Children's Hospital of Chicago

When it comes to making sure our little ones are set up for success at home and at school, a largely underestimated area of pediatric development is their eye health. From doing homework to watching Bluey to learning a new sport and beyond—our kiddos’ eyes play a vital part in their health and wellness.

So when our children start coming of age to see the eye doctor or start having vision changes, we want to make sure we’re setting ourselves up for success. The experts from Ann & Robert H. Lurie Children’s Hospital of Chicago are our go to when seeking advanced and specialized care and need-to-know info. If you’re looking for answers surrounding all-things childhood eye health, look no further: we’ve rounded up your frequently asked questions with answers from the experts in the Ophthalmology division at Lurie Children’s.

Meet the expert
Noreen Shaikh, OD, MEd
Optometrist, Ophthalmology

Meet the expert
Kelly Laurenti, MD
Attending Physician, Ophthalmology

Meet the expert
Jennifer Rossen, MD
Attending Physician, Ophthalmology
Meet the expert
Magdalena Stec, OD
Optometrist, Ophthalmology

 

How often should my child be getting their eyes examined by a specialist?

We know that our kiddos have to see an eye specialist at some point, but if you’re wondering exactly when, you’re not alone. The experts at Lurie Children’s have a simple answer. “If you have no concerns about your child’s eyes or vision, their first eye exam should be when they’re between 2 ½ to 3 years old. If everything is normal, then every 1-2 years through childhood,” they stated. If you have any concerns before that time, or if you have a family history of eye disease or vision problems, they noted that earlier evaluations may be necessary.

 

My child is squinting—what could be causing it?

Squinting is one of the most common signs that your child may have a vision disturbance. Per the experts at Lurie Children’s, squinting may be the result of the following issues:

  • Blurred vision: This may be caused by a number of factors including an uncorrected refractive error such as myopia (nearsightedness), hyperopia (farsightedness), or astigmatism (blurriness at all distances).
  • Strabismus: one eye wandering in or out.
  • Light sensitivity: This can be caused by astigmatism, strabismus, or larger pupil size.

 

eye exam

Source: Shutterstock

 

What are some other signs and symptoms indicating I should take my child to the eye doctor?

Outside of squinting, children may display some other signs that would warrant a trip to the eye doctor. Per the specialists at Lurie Children’s, you may need to see an eye specialist if your child exhibits the following symptoms:

  • Rubbing one or both eyes
  • Closing one eye
  • Head turn or tilt
  • Constant tearing or discharge from either eye
  • Frequent blinking
  • Eye wandering out or crossing
  • Red eyes
  • Light sensitivity
  • Headaches
  • White eye reflex seen on photos
  • Eye pain
  • Bringing things close to their face
  • Failed vision screening

If you notice your child exhibiting one or more of the above symptoms, be sure to follow up with your pediatrician for an evaluation and a possible referral to an eye doctor.

 

How are pediatric eye conditions treated?

When we asked the experts at Lurie Children’s how certain eye conditions are treated, they noted that interventions are dependent on what condition the child is diagnosed with. In some cases, lifestyle modifications such as including screen hygiene (looking away from screens every 20 minutes), lid hygiene, and diet may be enough to treat certain conditions. In other cases, glasses and contact lenses may be a solution for visual disturbances. Other times, patching one eye may be indicated, especially in circumstances where one eye is stronger than the other. If the goal of treatment is myopia (nearsighted) control, your child may need eye drops or contact lenses for correction.

For certain eye diseases or infections, specialized eye drops may be necessary. The experts at Lurie Children’s also note that in other conditions (such as strabismus/crossed-eyes), refractive or surgical correction may be needed. Certain more severe conditions may require surgical interventions, laser treatments, or an interdisciplinary approach with multiple specialists working together as a team to treat more complex systemic conditions.

 

If my child needs glasses now, is there a chance they grow out of it?

When questioned about how long children who are prescribed glasses may need glasses, the specialists at Lurie Children’s stated that kids may grow out of their prescription, especially in circumstances where children are diagnosed with hyperopia (farsightedness). “Most children are hyperopic because their eyes are smaller. As they grow, the length of the eye increases causing them to grow out of that farsightedness,” they noted.

Per the experts, if a child has astigmatism, it is unlikely to resolve. “Astigmatism occurs when the curvature of the front surface of the eye resembles the shape of a football, rather than being a perfect sphere like a soccer ball. It typically stabilizes in early childhood and persists through adulthood,” they noted.

They went on to note that if a child is myopic, it is unlikely that they will grow out of the prescription as myopia tends to be progressive. “We see the most myopic progression or increase to nearsightedness between the ages of 8-12, though it may continue to increase into their 20s,” they stated. They rounded out the conversation by noting that if a child has a significant refractive error, their glasses are prescribed to prevent them from developing amblyopia (a lazy eye in which the eye is not capable of seeing 20/20 with or without glasses).

 

 

What can I expect during my child’s visit to the eye doctor?

 

Initial workup

The Lurie Children’s specialists walked us through a typical appointment to help prepare us for what we may experience during a trip to the eye doctor. During the initial workup, an ophthalmic technician will take a history where they ask about the child’s medical history, family history, medications, and allergies. They’ll also ask about any symptoms that the patient is experiencing pertaining to their eyes or vision. From there, a further workup may include:

  • Visual acuity at distance and near: If a child is old enough, this can be tested with shapes or letters. In babies and in non-verbal children, vision is tested with preferential looking cards which display lines of varying degrees to determine if they prefer to look towards them or not.
  • Stereopsis or depth perception: Patients wear 3D glasses and point out animals and shapes that appear three-dimensional.
  • Color vision testing: The patient is evaluated with screening tools to detect forms of color blindness.
  • Pupil testing: To determine pupil shape, size, and reactivity to light.
  • Extraocular motility: The patient is directed to look in different directions to determine eye muscle function.
  • Ocular alignment: A measurement of how well eyes work together as a team to determine if there’s any wandering or crossing.
  • Intraocular pressure: A gentle tool is used to measure the pressure inside the eye (no air puff needed!).

 

Eye dilation

After the workup, the child’s eyes are dilated using eye drops. The eye drops dilate the pupils and relax the focusing system causing vision to become a bit blurry for a few hours. Per the experts at Lurie Children’s, the purpose of the dilation is two-fold.

First, it helps the doctor to visualize the structures in the back of the eye (i.e. the retina and the optic nerve), and, secondly, it helps to relax the focusing system which allows the doctor to objectively determine the refractive error (i.e. glasses prescription). Children have very strong focusing systems. Without the dilation, the measurement fluctuates, making it difficult to determine the true refractive error.

 

Doctor exam

After about 30-40 minutes, the dilation is complete and the doctor performs their part of the exam. This exam consists of:

  1. Refractive error determination: By looking through a light and holding up different powered lenses, as described above.
  2. Health eye assessment: By using magnifying lenses and lights to visualize both the anterior and posterior aspects of the eye.
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This post is in partnership with Ann & Robert H. Lurie Children’s Hospital of Chicago but all of the opinions within are those of The Everymom editorial board. We only recommend products we genuinely love.