Childhood Eye Disorders

August 7, 2013

Disorders of the eye can be detrimental at any age, but can be especially devastating in childhood. Many of these conditions can be terrifying, especially to a nervous parent; thankfully, many congenital disorders and/or disorders developed in childhood can be treated and kept in check, even if they are not “curable.” In April, we discussed one such childhood disorder, retinoblastoma ( This week, we’ll dive into some less frightening disorders of childhood: amblyopia, strabismus, and refractive errors.


Developmental problems in the brain causing delayed or stunted visual development are most often the cause of amblyopia, or “lazy eye.” Within childhood visual development, there is a period of critical development which, if treatment for amblyopia is not adhered to, can cause lifelong visual limitations. What makes determination and treatment difficult is the ability of the brain to compensate for poor vision, out of one eye especially; children affected by amblyopia may not even realize that they have limitations. Amblyopia is usually congenital and can be secondary to other eye conditions, including congenital cataracts, strabismus (misaligned eyes), and anisometropia (unequal refractive error between the two eyes).

Treatment, often in the form of patching or blocking the vision of the better seeing eye, can be integral to increasing the visual capabilities. Difficulties arise in compliance, especially with children adhering to advised treatments. Parents are urged to be vigilant in recommended treatments; vision not developed within the fundamental visual development period is lost forever. After the visual developmental period is over, no further treatments have significant effects on vision in amblyopic eyes, and children may be excluded from certain careers (and are more at risk for limited capabilities if better seeing eye is damaged).


Strabismus is a condition where the eyes are misaligned; this may be a constant or may be intermittent, somewhat controllable or completely uncontrollable. While it is a relatively rare condition, it is estimated that it is present in approximately 4% of children. Advised treatments should be begun as soon as possible to ensure the best possible visual outcome; treatments include surgery on the muscles of the eyes, prisms in refractive spectacles, and monitoring. Symptoms include an eye that turns out, in, up, or down; this may switch between either eye, or may be only affecting one eye; further, constant or intermittent misalignment may be noted. During your child’s examination, testing may be performed to attempt to cause the affected eye(s) to deviate if it is not immediately apparent.

Refractive Errors

Refractive errors are simply the visual disorders many of us are born with or develop; nearsightedness, astigmatism, and farsightedness are common refractive errors. It is important to treat these in childhood with glasses, if deemed necessary by your eye care professional. Some symptoms of refractive errors include sitting more closely to the television, holding books closer while reading, squinting, and complaining of poor vision. Teachers and parents may notice a decrease in performance in school or difficulties reading the chalk/smartboard or books. Determination of refractive error is often a simple, non-invasive eye examination.