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Most of a child’s early learning is visual, so their development depends on the ability to see. But children can experience a variety of vision issues.

Decreased vision commonly occurs because of refractive errors, which happen when the eye can’t focus light correctly, says Taryn Fletcher, an ophthalmologist in Joburg. Children are born far-sighted, says Fletcher, and develop normal vision as they grow. But some become short-sighted, often complaining that they can’t see the board.

Another condition is amblyopia, or lazy eye. If one eye is blurry, or weaker than the other, the brain ignores the image from the weak eye. Children may prefer using one eye, can’t follow objects with the weaker eye, or don’t want the strong eye covered.

A squint, or strabismus, is an inward or outward turning of the eye, says Fletcher, caused by reduced vision or an imbalance of the eye’s muscle strength.

Cataracts and glaucoma can also occur in children, says Helen White from Orbis Africa, a non-profit organisation committed to saving sight in Africa. A cataract is a clouding of the lens, and shows up as a white spot on the pupil, while glaucoma is an increase in internal eye pressure. Tumours are rare, but can happen; they may show up as a white spot, so can be mistaken for a cataract.

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See to it

Catching vision problems early is essential. Left to themselves, these conditions can worsen and cause permanent damage. Paediatricians can pick up problems early, or children can see an optometrist or ophthalmologist for vision and eye testing. This can be done on pre-verbal children and those who can’t yet read by checking focus or using pictures, notes Fletcher. Children should have a vision screening by the time they’re three years old. Teachers also play a role in early identification, as they’re often in the best position to notice problems, says White. Some common signs to look out for, says Fletcher, include red eyes, a white spot on the pupil, watering eyes, bulging eyes, a droopy lid, eye rubbing, or the presence of pus.

Once eye problems have been picked up, they can usually be treated with glasses, contact lenses, or lenses implanted in the eye in patients with very high refractive errors. Fletcher says contact lenses are better for very young children, or those that can follow instructions well. Patching or dilating drops can be used to treat amblyopia. Surgery may be required for some conditions.

Read more about why good eyesight is important for learning.

Overriding perceptions

Detecting vision problems early is one thing; getting children to comply with the treatment is another. Helen White says many children don’t wear glasses as they’re afraid of being bullied or looking different. Some don’t know how important it is to wear their glasses. It’s up to parents and teachers to ensure children follow through with their treatment, says White.

Parental involvement

Parents need to tell teachers that their child requires glasses, and when they should wear them, while teachers can ensure no one laughs at a child who has to wear glasses. Parents can engage children in fun activities that require them to wear glasses, such as reading a book, until the child gets used to the prescription.

Tamlyn Vincent