A child’s vision gets stronger each year. This improved vision is needed as the child explores the world more fully and begins school.
The developing eye is learning to do many things better, such as:
- accommodation or eye focusing. This allows the eye to quickly change focus between distances.
- seeing things in 3D (three dimensions). This is known as depth perception.
- tracking, which helps the eyes follow a moving target.
- convergence, which helps both eyes focus together on an object at the same time.
As you watch your child grow, look for these vision development milestones:
At 3 to 4 years old
- Enhanced hand-eye coordination and fine motor skills. This is evident as a child is stronger with puzzles or building toys.
- Improved visual memory helps children copy shapes like a circle when drawing. They may recall certain memories to tell a story visually.
- Can read most lines of eye chart.
At 4-6 years old
- Letter and object recognition. A child begins reciting the alphabet and naming different types of money.
- Reading skills. Improved convergence (eyes moving together) helps a child follow the words from left to right across the page.
- When both eyes work well together, depth perception is fully developed. This helps a child judge distances between objects and themselves. A child with good depth perception feels comfortable playing sports or simply moving through the world confidently.
Watch for milestones, but remember that children develop at different rates. While delays can be normal, when you see one, discuss with your doctor. Keep an eye out for signs of vision problems, like head tilting, blinking or squinting a lot or avoiding reading.
Common Childhood Vision Problems
Refractive errors are very common. They cause blurry vision and are corrected with glasses. There are three main refractive errors:
- Farsightedness (hyperopia). Close objects are blurry to a child (such as when reading), and distant objects are seen more clearly. Most children are minimally to moderately farsighted.
- Nearsightedness (myopia). A child sees near objects more clearly than distant objects. Children with myopia should get an eye exam before and during growth hormone therapy.
- Astigmatism. With astigmatism, near and far vision are blurry. It's almost like looking into a fun house mirror in which you appear too tall, too wide or too thin.
It is possible to have two or more refractive errors at the same time. Without treatment, refractive errors can lead to more serious vision problems.
Strabismus is when the eyes are misaligned and point in different directions. For healthy vision to develop into adulthood, both eyes must work together.
Amblyopia (lazy eye) is when one or both eyes do not develop normal vision during childhood. Eye problems like strabismus or refractive errors keep the eye from seeing correctly. This leads to a lazy eye.
A child is not likely to tell you their vision is blurry. And often, a parent does not see signs of strabismus, amblyopia or refractive errors. This is why it’s so important to screen for eye disease during these critical years.
Tips to Help Your Child’s Vision as They Grow
Sharpen your child’s vision skills with these toys and activities:
- Puzzles, building blocks, peg boards and similar toys for hand-eye coordination
- Making jewelry/stringing beads
- Painting and drawing
- Playing catch with a soft, child-safe ball
Protect your child’s vision with:
Outdoor Play and Myopia
More time outdoors may lower a child’s risk for myopia. A study looked at kids spending 40 extra minutes outdoors each day. These kids lowered their risk of getting myopia or more severe myopia (stronger prescription/eyeglasses). The kids who spent more time indoors (reading or on their computer devices) were more likely to get myopia or severe myopia.
While there is no direct link, the study supports the idea that balancing outdoor time with indoor time is beneficial for a child’s health and well-being.