What Are Common Paediatric Eye Problems?
Your child’s eyes are constantly developing from their first few months of life to the teenage years. But because children often can’t describe what they see or feel, it can be tricky to know when something’s wrong.
Many paediatric eye problems start small and are completely treatable if spotted early. But without proper diagnosis, they can lead to long-term vision issues or even permanent loss of sight in one eye.
In this article, we’ll look at the most common paediatric eye conditions, what symptoms to watch for, and when to see a paediatric ophthalmologist in London for a professional assessment.
Why Early Eye Care Matters
A child’s vision develops rapidly during the first seven to eight years of life. During this time, the brain learns how to process visual information from both eyes.
If one eye doesn’t send clear signals for example, due to misalignment or blurry focus the brain may start ignoring it. This can cause amblyopia, or “lazy eye.”
Early intervention is key. Most paediatric eye conditions respond well to treatment when identified before the visual system fully matures.
Regular eye checks can catch subtle signs that parents may miss, such as poor depth perception, head tilting, or frequent blinking.
1. Refractive Errors (Shortsightedness, Longsightedness, and Astigmatism)
What It Is:
Refractive errors are the most common cause of blurred vision in children. They occur when the shape of the eye prevents light from focusing properly on the retina.
Types:
- Myopia (Shortsightedness): Distant objects appear blurry, while close objects are clear.
- Hyperopia (Longsightedness): Close objects are blurry, but distance vision may be fine.
- Astigmatism: Vision is distorted at all distances due to irregular curvature of the cornea or lens.
Common Signs:
- Squinting while watching TV or reading.
- Sitting very close to screens or books.
- Complaints of headaches or eye strain.
- Poor performance in school (especially when reading from the board).
Treatment:
Glasses or contact lenses can correct most refractive errors. In some cases, orthokeratology (overnight lens reshaping) or myopia control lenses may be recommended for children at risk of progressive short-sightedness.
2. Amblyopia (Lazy Eye)
What It Is:
Amblyopia develops when one eye sends weaker visual signals to the brain. The brain starts favouring the stronger eye, suppressing input from the weaker one.
Why It Happens:
It’s often caused by:
- Uncorrected refractive error in one eye.
- Strabismus (eye misalignment).
- Obstruction in vision (e.g., congenital cataract or droopy eyelid).
Warning Signs:
- The child seems to rely on one eye.
- The lazy eye appears to drift or “turn off.”
- Difficulty judging distances or catching objects.
Treatment:
Early treatment is crucial. Options include:
- Corrective glasses or lenses.
- Patching the stronger eye to train the weaker one.
- Atropine drops to blur vision in the stronger eye.
- In some cases, surgery may be needed for the underlying cause (like a squint).
With early intervention, most children achieve excellent improvement in vision.
3. Strabismus (Squint or Crossed Eyes)
What It Is:
Strabismus occurs when the eyes do not align properly one may turn inward, outward, upward, or downward.
When It Starts:
It can appear at birth (congenital strabismus) or develop later due to muscle imbalance, refractive error, or neurological causes.
Common Signs:
- One eye drifting while the other stays straight.
- Tilting or turning the head to focus.
- Complaints of double vision.
- Poor depth perception.
Treatment:
Strabismus treatment depends on the cause and severity:
- Glasses can correct misalignment caused by focusing problems.
- Prism lenses may help realign visual images.
- Vision therapy exercises strengthen coordination.
- Surgery may be needed to adjust eye muscle positioning.
Early management prevents amblyopia and helps the eyes work together effectively.
4. Congenital Cataracts
What It Is:
A cataract is a clouding of the lens that blocks light from reaching the retina. While often associated with ageing, cataracts can also be present at birth (congenital).
Causes:
- Genetic mutations.
- Maternal infections during pregnancy (e.g., rubella).
- Metabolic disorders or trauma.
Warning Signs:
- White or cloudy pupil appearance.
- Poor tracking of objects or lack of eye contact.
- Rapid, uncontrolled eye movements (nystagmus).
Treatment:
If cataracts are significant, surgery is usually required within the first few months of life to prevent permanent vision loss. After removal, contact lenses or intraocular lenses restore clear vision.
Follow-up care ensures proper visual development after surgery.
5. Conjunctivitis (Pink Eye)
What It Is:
Conjunctivitis is inflammation of the thin membrane (conjunctiva) covering the white of the eye and inner eyelid.
Types:
- Viral: Often associated with colds and spreads easily.
- Bacterial: Causes sticky discharge and redness.
- Allergic: Triggered by pollen, dust, or pet dander.
Symptoms:
- Red, itchy, or watery eyes.
- Sticky discharge (especially after waking).
- Sensitivity to light.
Treatment:
- Bacterial: Antibiotic eye drops or ointments.
- Viral: Usually clears on its own within 1–2 weeks.
- Allergic: Antihistamine drops and allergen avoidance.
Keep your child’s towels, pillows, and tissues separate to prevent spread.
6. Ptosis (Droopy Eyelid)
What It Is:
Ptosis is when one or both upper eyelids droop lower than normal.
Why It Matters:
In severe cases, it can block vision and affect eye development, leading to amblyopia.
Causes:
- Congenital muscle weakness.
- Nerve problems.
- Injury or surgery.
Symptoms:
- Uneven eyelid height.
- Child lifting chin or eyebrows to see clearly.
Treatment:
If mild, regular monitoring may be enough. For severe cases, eyelid surgery (ptosis repair) helps restore normal vision and appearance.
7. Blocked Tear Ducts (Nasolacrimal Duct Obstruction)
What It Is:
A blocked tear duct prevents tears from draining normally into the nose, leading to excessive tearing.
Common in:
Newborns and infants often resolves naturally within the first year.
Symptoms:
- Constant watery eyes.
- Mucus or discharge collecting near the lashes.
- Mild redness near the inner corner of the eye.
Treatment:
- Gentle massage along the tear duct can help open it.
- Warm compresses soothe irritation.
- If blockage persists beyond one year, a minor surgical procedure (probing) may be recommended.
8. Chalazion and Stye
What They Are:
Both are lumps along the eyelid caused by blocked oil glands.
- Stye: Painful and red; caused by bacterial infection.
- Chalazion: Painless and firm; results from chronic blockage.
Symptoms:
- Localised swelling or redness.
- Tenderness or discomfort when blinking.
- Occasionally blurred vision if swelling presses on the eye.
Treatment:
- Warm compresses several times a day.
- Antibiotic ointment for infection.
- Persistent chalazia may need minor surgical drainage.
9. Keratoconus in Teenagers
What It Is:
Keratoconus causes the cornea to thin and bulge into a cone shape, distorting vision.
When It Appears:
Typically begins in the teenage years and can progress rapidly.
Symptoms:
- Blurred or double vision.
- Frequent changes in glasses prescription.
- Sensitivity to light.
Treatment:
- Specialised contact lenses (rigid or scleral) to reshape the cornea.
- Corneal cross-linking to strengthen the cornea and stop progression.
- Advanced cases may need corneal transplant surgery.
Early detection makes a major difference children rubbing their eyes excessively should always be checked.
10. Eye Injuries
What They Are:
Eye injuries in children are common due to sports, toys, or accidents. Even minor trauma can lead to infection or scarring if untreated.
Warning Signs:
- Redness, pain, or watering after an impact.
- Vision changes or light sensitivity.
- Foreign object sensation that doesn’t go away.
What to Do:
Avoid rubbing the eye and seek immediate care. Delaying treatment can worsen damage or lead to infection.
Paediatric eye specialists can evaluate injury severity and ensure full recovery without long-term vision loss.
When to See a Paediatric Ophthalmologist
You should seek professional advice from a paediatric ophthalmologist in London if your child:
- Frequently rubs their eyes or blinks excessively.
- Holds objects too close to their face.
- Has a squint, droopy eyelid, or one eye that looks different.
- Complains of headaches or blurred vision.
- Has watery, red, or sticky eyes that don’t clear up.
Even if symptoms seem mild, an eye specialist can detect subtle issues that standard vision screenings may miss.
Importance of Regular Eye Tests
Routine eye exams are essential for maintaining visual health, especially before school age.
Recommended Schedule:
- Newborn screening: Basic eye health check.
- 6–12 months: First comprehensive eye exam.
- 3–5 years: Screening for lazy eye or squint.
- Before school age and every two years thereafter: To detect refractive errors early.
Children with family histories of eye conditions, premature birth, or developmental delays may need more frequent checks.
How Parents Can Help Maintain Healthy Vision
- Encourage Outdoor Play
Spending at least two hours a day outdoors is shown to reduce the risk of myopia.
- Limit Screen Time
Prolonged screen use causes digital eye strain. Follow the 20-20-20 rule: every 20 minutes, look 20 feet away for 20 seconds.
- Promote Eye Hygiene
Teach children to avoid rubbing their eyes and to wash hands regularly to prevent infections.
- Provide Balanced Nutrition
Foods rich in vitamin A, C, omega-3 fatty acids, and lutein support healthy eye growth.
- Use Protective Eyewear
Goggles during sports or crafts can prevent serious eye injuries.
Advances in Paediatric Eye Care
Modern paediatric ophthalmology now includes technologies such as:
- Digital retinal imaging for non-invasive eye scans.
- Automated vision screening tools for preverbal children.
- 3D surgical visualisation for precision in strabismus or cataract correction.
- Myopia management programmes using lens design and lifestyle tracking.
These advances mean early intervention is more effective and less invasive than ever before.
The Emotional Side of Vision Problems in Children
Poor vision can affect a child’s confidence, learning, and social life. Some children may be teased for wearing glasses or have difficulty keeping up in class.
Reassurance, positive reinforcement, and involving your child in choosing their glasses or treatments can make the process smoother.
Schools can also offer extra support for children with vision challenges, including front-row seating or larger-print materials.
FAQs About Paediatric Eye Problems:
- How can I tell if my child has a vision problem?
You might notice your child squinting, tilting their head, or sitting too close to screens or books. Sometimes they may complain of headaches, rub their eyes often, or struggle to follow words while reading. But many children don’t mention blurry vision because they assume what they see is normal. That’s why regular eye check-ups are so important an ophthalmologist can spot early issues before they start affecting your child’s development. - At what age should my child have their first eye exam?
Your child’s first eye exam should happen between 6 and 12 months of age. Even if everything seems fine, it’s best to have another exam around 3 to 5 years old to check for conditions like lazy eye or squint. After that, you should schedule tests every two years, or more often if your child has a family history of eye problems. Early eye care can make all the difference in protecting their long-term vision. - My child often blinks or rubs their eyes should I be worried?
Frequent blinking or rubbing can sometimes be harmless, like a response to tiredness or dry air. However, if it happens often or comes with redness, watering, or light sensitivity, it may point to an underlying issue such as allergies, eye strain, or even an early refractive error. It’s best to have an eye specialist take a closer look, just to rule out anything serious. - Can too much screen time damage my child’s eyes?
Screens don’t permanently damage the eyes, but they can cause temporary discomfort known as digital eye strain. You may notice your child complaining of sore, dry, or tired eyes after long periods of screen use. To help, encourage regular breaks using the 20-20-20 rule: every 20 minutes, look 20 feet away for 20 seconds. Balancing screen time with outdoor play also helps reduce the risk of developing myopia, or short-sightedness. - What is the difference between a paediatric optometrist and a paediatric ophthalmologist?
A paediatric optometrist checks vision, prescribes glasses, and screens for common problems like lazy eye or squint. A paediatric ophthalmologist, on the other hand, is a medical doctor who can diagnose and treat complex eye diseases, perform surgery, and manage conditions involving the eye muscles or nerves. If your child needs more specialised care or surgery, you’ll likely be referred to an ophthalmologist. - Is it normal for babies’ eyes to appear crossed sometimes?
It’s quite common for newborns’ eyes to wander or appear misaligned during the first few months of life. Their eye muscles are still developing, and coordination improves with time. However, if your baby’s eyes remain crossed or misaligned beyond six months, it’s worth getting them examined. Persistent misalignment could be a sign of strabismus, which responds best to early treatment. - Can a lazy eye be completely cured?
Yes if detected early, a lazy eye (amblyopia) can often be corrected successfully. Treatment usually involves patching the stronger eye or using special drops to encourage the weaker one to work harder. The earlier you start treatment, the better the results. Once the visual system fully develops usually by age eight or nine it becomes harder to reverse. That’s why early diagnosis is key. - Are children’s eye surgeries safe?
Modern paediatric eye surgeries, such as cataract removal or strabismus correction, are very safe and performed under general anaesthesia. Advanced imaging and microsurgical tools allow surgeons to operate with extreme precision. While every procedure carries some risk, outcomes for children are generally excellent when performed by experienced paediatric ophthalmologists. Regular follow-ups after surgery ensure proper healing and visual development. - What can I do at home to keep my child’s eyes healthy?
You can make a big difference by encouraging healthy habits. Make sure your child spends at least two hours a day outdoors, eats a balanced diet rich in fruits, vegetables, and omega-3 fats, and gets enough sleep. Teach them to avoid rubbing their eyes and to wash their hands often to prevent infections. You can also help them develop good screen habits taking regular breaks and keeping screens at a comfortable distance. - When should I take my child to an eye specialist urgently?
You should seek immediate care if your child suddenly complains of severe pain, blurred or double vision, light sensitivity, or if you notice redness, swelling, or discharge that doesn’t improve. Sudden vision changes, a white reflection in the pupil, or an eye injury also need urgent attention. Even if you’re unsure, it’s always better to get professional advice early treatment can prevent lasting damage.
Final Thoughts: Caring for Your Child’s Eyes Early Makes All the Difference
Your child’s eyes play a vital role in how they explore and understand the world from learning in school to building confidence and independence. The earlier you identify and treat paediatric eye problems, the better the chances of achieving lasting, healthy vision. Even minor symptoms like frequent blinking, squinting, or holding books too close can signal something more serious that deserves attention.
By scheduling regular eye exams and responding quickly to changes in your child’s visual habits, you’re giving them the best possible start. Modern advances in paediatric ophthalmology mean that most conditions can be treated safely and effectively especially when caught early. If you’re considering paediatric ophthalmologist in London, our team at Eye Clinic London can guide you through every step from diagnosis to treatment and ongoing eye care ensuring your child’s vision gets the best possible support.
References:
- Ziziuchin, V., Horgen, G. & Sundling, V. (2025) ‘Refractive Error and Ocular Pathology of Children Examined in an Ophthalmological Practice in Moldova’, Journal of Clinical Medicine, 14(5), 1554. Available at: https://www.mdpi.com/2077-0383/14/5/1554
- Teran, E., Romo-García, E. & Santiago, H.C. (2024) ‘Refractive Errors of School Children from Economically Disadvantaged Areas in Northwest México’, Journal of Clinical Medicine, 13(11), 3094. Available at: https://www.mdpi.com/2077-0383/13/11/3094
- Gurung, G. et al. (2023) ‘Refractive Error among Children Visiting the Department of Ophthalmology in a Tertiary Care Centre’, [journal]. Available at: https://pubmed.ncbi.nlm.nih.gov/38289740/
- Tailor, V. et al. (2016) ‘Childhood amblyopia: current management and new trends’, Eye and Vision, [online]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5862311/
- Tegegne, M.M. et al. (2021) ‘Prevalence and Associated Factors of Amblyopia Among School Age Children in Bahir Dar City, Northwest Ethiopia’, [journal]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8140911/