Signs your child may have vision problems

Pediatricians can identify vision problems in children. However, there are signs parents themselves can spot.

Here are five signs that you as a parent should always be on the lookout for:

Eye misalignment

This condition, also called strabismus, is common among children. It is a crossing or drifting of the eyes; one or both eyes may turn inward, outward, up or down. Strabismus may be an indicator of a disorder affecting the child's brain. A cataract or eye injury may also be the cause, though most children who have strabismus don't have these problems, the American Academy of Ophthalmology (AAO) says. If strabismus isn't treated, it can lead to poor vision, specifically a condition called amblyopia.

Some young children's eyes may look crossed when they really aren't. This condition, called pseudostrabismus, can occur if the child has a wide, flat nose or a fold of skin at the inner eyelid. Pseudostrabismus doesn't require treatment as children tend to outgrow the condition as facial features mature over time.

"True strabismus that is present after the first few months of age is usually not outgrown and requires an exam by a specialist," says Samantha Feldman, M.D., a pediatric ophthalmologist at the Krieger Eye Institute. "A specialist may also be needed to tell the difference between pseudostrabismus and true strabismus."

Squinting

Another common eye problem in children, squinting-the act of looking at someone or something with one or both eyes partly closed-can be associated with strabismus or refractive errors such as nearsightedness, farsightedness or astigmatism. As a parent, be mindful of your child squinting, holding objects really close or sitting close to the TV or other devices.

Abnormal head positioning

Some children may turn or tilt their head in a certain position in order to see better.

"Although abnormal head positioning can be behavioral or due to a problem with the muscles in the neck, it is important to evaluate all of these children for eye misalignment and shaking of the eyes, called nystagmus," Feldman says. "If they're always keeping their head in one position, it can alert you that maybe something is going on."

White pupil (easiest to see in photos taken with flash)

Sometimes, leukocoria (white pupillary reflex) is reflected in photographs using a flash when one pupil is abnormally "white" and the other is the normal black or red color. "With leukocoria, we worry about things like a cataract, a tumor inside the eye, eye misalignment or a need for glasses. If a parent notices this at home, they should bring it up to the pediatrician right away," Feldman says.

Eyelid drooping

"If one eyelid is really low, sometimes that can cause poor vision as well," Feldman says.

Many children have no outward signs of vision problems, which is why regular screenings at school or the pediatrician's office are strongly encouraged.

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