Does My Toddler Really Need Glasses?

Many parents are completely devastated when they are told that their toddler needs glasses. They refuse to believe that such a small child can have compromised vision. And they ask the question “Does my toddler really need glasses?” As parents they are horrified when they realize that their child’s vision requires correction and they are ready to do exercises – diets and everything else that can keep the glasses away.

But there is no minimum age for glasses. And since one of the commonest questions that parents ask is – “Should a five year old wear glasses?” – I am answering it first.

At the end of the article watch a video by renowned pediatric opthalmologist Dr Anirudh Singh MBBS,MS,DNB,FAICO to understand how to know if your toddler really needs glasses

Should a five year old wear glasses?

Yes – your five year old may need glasses because vision problems like Myopia can occur in a child at any age.

Eye problems can occur in

1. Newborns
2. Toddlers and pre-schoolers
3. Older children – school going age
4. Teenagers in their early teens

It is important to look out for eye problems in a child at all ages

When to do the first Eye check-up for a child?

Eye check-ups for Newborns

The first eye check up for a baby who is born at full term ( on the expected date of delivery) should be done between 3 – 6 months of age.

In case of a pre-term baby – i.e. a baby who is born before the expected date of delivery – it is important to get the first eye check done immediately after birth.

A lot of parents think that it may not be possible to examine the eyes of a newborn baby – but this a misconception. There are various methods to check the eye sight of children at various ages and you must start bringing your child for check-ups within 6 months of birth

Always remember that eye problems can occur at any age right from the time a child is born. And eye problems especially problems like short sightedness when left undiagnosed for a long time – can rapidly lead to loss of eye sight. So it is important to begin eye check-ups early in life and also to repeat the eye check-ups at the prescribed

How to tell if your toddler needs glasses?

Step 1 – Watch out for vision problems in babies

 Suspect that your baby has an eye problem which could be short sightedness or a variety of other problems – in the following cases

1. By 3 months of age if you feel that your baby is not looking at a toy that you are moving in front of her/him.
2. If he/she is not recognizing the mother’s face and looks blankly into space or into the ceiling.
3. If your baby is not looking when people move around.

Step 2 – Watch out for vision problems in toddlers

Sometimes children who have completely normal eye sight as babies – start having difficulty seeing when they are around one and a half or two years of age. Suspect that your child has an eye problem in the following cases.

1. When you try to teach the child something he/she brings the object to be seen quite close to the face.
2. When the child tries to read he/she may close one eye while trying to read.
3. When you take the child outside in the sun he/she may try to close one eye to adjust to the outside light

These are indirect indicators which tell you that there is a vision problem and it is important for parents to be aware of these things

Go to an eye doctor immediately in the following cases –

1. Your toddler has a squint
2. Your toddler complains of headaches
3. You see your toddler frequently covering one eye
4. Your toddler struggles to read (frequently loses her/his place on the page while reading and cannot read without pointing to the word on the page)
5. Your child seems to have low attention span and avoids puzzles and games that require focus.
6. Your toddler frequently rubs her/his eyes
7. You find yourself calling your toddler clumsy (drops things or knocks over things)
8. Your toddler sits too close to the television set
9. Your toddler turns the head to one side or tilts the head or closes one eye while watching TV
10. You find your toddler’s eyes watering all the time
11. Your toddler gets scared in bright light and refuses to go out of the house in the bright sunlight
12. Your toddler says she/he cannot see the blackboard
13. When your child learns to write you find her/his hand writing is difficult to read
14. Your child copies things wrong from the blackboard

Activities that help vision development in Toddlers and pre-schoolers

Babies are born with very poor vision. The eyes and vision develop slowly over a period of several years.

The following activities help in the development of vision by stimulating the eyes

1. Playing outdoors in daylight for several hours in the day.
2. Stacking building blocks,
3. Coloring, (hand to eye coordination)
4. Cutting (hand to eye coordination)
5. Reading aloud to the child and showing her/him what you are reading
6. Playing with finger paints
7. Playing with chalk and board
8. Allowing enough time for free play without adult supervision

Eye check up when your child joins school

All children must have a thorough eye check up before joining school because when a child joins school the eyes need to focus differently.

When your child is a toddler – she/he is using her/his eyes primarily to look at distant objects. But when your child joins school she/he will have to focus on close objects. And this can cause eye problems to arise.

Please remember that your child will not be able to tell you that she/he can’t see. Children believe that their vision is normal and believe that everyone else is also seeing the world the way they are.

The importance of toddler vision test

The first eye check up for a baby must be done by 6 months of age.

After the first eye check up  at six months – bring your child for a checkup every 6 months.

Sometimes children are all OK – till they reach one or two years of age.   But by the time they are around one and a half  or two and they actually start looking at near  things which means that they start reading or they start looking at toys closely – they start using their near vision more and some problems start showing up at that time. So this is the age when a second check-up is definitely required

Visual Acuity Testing Using Eye Charts

For toddlers and preschoolers between 3 to 5 years of age vision testing is done using eye charts which use pictures, letters or numbers

Visual acuity for distant objects is written as a fraction, such as 20/20.

The number on top is the distance of the chart from the person reading it (20 feet) The number below is the distance from which a person with a normal eye can read the smallest line on the chart.

Why do some doctors sometimes delay prescribing glasses for children?

Since visual acuity develops slowly – there are different normal for different ages. And the doctor has to decide whether the child’s vision is normal for her/his age. Or if she/he needs glasses to correct the refractive error.

Can a child be given glasses even when she/he has normal vision?

Glasses or other corrective measures may be prescribed by the doctor even when the vision is completely normal in some cases

1. When the visual acuity for the two eyes is different
2. When there is a squint
3. When there is lazy eye

If you have a history of eye problems in your family – make sure you mention this to the doctor.

How often should vision testing be done?

It is important to check your child’s vision every 6 months.

1. To prevent the development of low self-esteem
   This is important because in most cases the child may never complain about not being able to see.But because of his/her eye problems she/he may fall behind in school work – like reading and writing. And may develop poor self-esteem because of being scolded for not reading, having poor handwriting and making mistakes in copying things from the board.It is very important not to allow that to happen and so it is important to get the eyes checked even when a child has no complains about vision.
2. To prevent blindness in one eye
   In some cases only one eye of a child may be affected. That is the most sinister problem When one eye is good – the child does not complain of anything. But the eye that is bad or the lazy eye keeps getting lazier and lazier And it reaches a point where it cannot be corrected and the child goes blind in one eye.So that is the reason it is recommended that children are examined by an eye specialist every six months as they are growing up.

Adjusting to glasses the first time

When children start wearing glasses – they are often irritable and refuse to wear their glasses

To help your child adjust to glasses for the first time – do the following

1. Encourage instead of getting impatient – It is only when your child wears the glasses that her/his eyes and brain gets used to the glasses. Your child is bound to feel some amount of eye pain, headache and dizziness. Empathize with your child but insist that she/he wears the glasses as soon as the symptoms pass.
2. Ensure that the glasses fit snugly and do not slip down the nose – If the specs slide down the nose your child may not be looking through the optical center of the glasses making it even more uncomfortable for her/him to see.
3. Clean the glasses regularly – Kids tend to dirty their glasses much more than adults do. And so their glasses need to be cleaned more often. Looking through hazy glasses is not a pleasant experience and it will make your toddler hate her/his glasses.
4. Get your child’s eye rechecked – Toddlers take between 1 to 3 weeks to get used to their glasses. If your toddler is still complaining after trying for three weeks – get the prescription checked again.

Watch this video to know how to know if your toddler really needs glasses

Dr Anirudh Singh  MBBS, MS (Ophthalmology) DNB (Ophthalmology) is a highly qualified and extremely accomplished paediatric ophthalmologist and an associate professor in ophthalmology. He has trained in paediatric ophthalmology and strabismus at the All India Institute of Medical sciences (AIIMS) has a fellowship in Paediatric Ophthalmology and Strabismus (FAICO). He also has a a certificate on Paediatric ophthalmology (ORBIS)