Ophthalmologist Dr. Ola Alsaed explains the rise in childhood vision problems, the warning signs parents often miss, and how early habits can safeguard your child’s eyesight.

What are the most common eye problems you see in children today?

The most common conditions include refractive errors such as myopia (short-sightedness), hyperopia (long-sightedness), and astigmatism. We also frequently see amblyopia (lazy eye), strabismus (squint), allergic eye disease, and increasingly, digital eye strain related to screen use. In many regions, progressive childhood myopia is becoming particularly prominent.

Are childhood eye conditions becoming more common, and if so, why?

Yes, particularly myopia. There is strong evidence that increased screen time, prolonged near work, reduced outdoor activity, and urban lifestyles contribute to rising rates of short-sightedness globally. Environmental factors combined with genetic predisposition are driving this trend, and children are developing myopia at younger ages than before.

At what age should parents begin routine eye checks for their children?

Eye health assessments should begin in infancy. Newborns are typically screened at birth. A comprehensive eye examination is recommended between ages 3 and 4, or earlier if there are concerns. If there is a family history of eye conditions such as strabismus or high refractive error, earlier evaluation is advisable.

What warning signs suggest a child may have a vision problem?

Common warning signs include squinting or closing one eye, sitting very close to screens or holding books too near, frequent eye rubbing, head tilting, complaints of headaches, poor concentration, avoidance of reading, or visibly misaligned eyes. In infants, lack of eye contact or failure to track objects may signal concern.

Are there behaviours – like rubbing eyes or sitting too close to screens – that parents often overlook?

Yes. Frequent eye rubbing is often dismissed as tiredness but can signal allergies or refractive errors. Sitting too close to screens or the television can be an early sign of myopia. Excessive blinking, short attention span during visual tasks, or covering one eye are also commonly overlooked indicators.

How are eye exams different for infants and toddlers compared to older children?

For infants and toddlers, examinations are largely observational and objective. We assess eye alignment, red reflex, fixation, and tracking. Special instruments allow us to measure refractive errors without requiring verbal feedback.

For older children, we can use visual acuity charts, binocular vision testing, and more detailed subjective refraction. The approach becomes more interactive as the child matures.

How do treatments vary between glasses, patching therapy, and medical or surgical options?

Treatment depends on the diagnosis. Glasses correct refractive errors and are often the first-line treatment. Patching therapy is used for amblyopia, encouraging the weaker eye to develop properly by covering the stronger eye. Atropine drops may be used for amblyopia or myopia control in selected cases. Surgical intervention is considered for certain types of strabismus, congenital cataracts, or structural abnormalities. Early diagnosis significantly improves outcomes.

Does screen time affect eye development or increase risks?

Excessive screen time is associated with digital eye strain, dry eye symptoms, and potentially increased risk of myopia progression. While screens themselves do not directly damage the eye, prolonged near focus without breaks contributes to visual stress and may influence long-term refractive development.

What habits help support healthy vision in young children?

Healthy habits include at least one to two hours of outdoor activity daily, limiting recreational screen time, following the 20-20-20 rule (every 20 minutes, look 20 feet away for 20 seconds), ensuring good lighting during reading, maintaining balanced nutrition rich in leafy greens and omega-3s, and scheduling routine eye examinations. Outdoor exposure in particular has been shown to reduce the risk of developing myopia.

What exactly is squint (strabismus), and why does it occur?

Strabismus is a condition where the eyes are not aligned and point in different directions. One eye may turn inward, outward, upward, or downward. It can result from muscle imbalance, refractive error, neurological factors, or developmental issues. Early treatment is crucial to prevent amblyopia and support normal visual development.

What non-surgical treatments are available today?

Non-surgical options include corrective glasses, prism lenses, patching therapy, atropine eye drops, and vision therapy exercises in selected cases. Many children respond very well to early, non-invasive interventions.

What advances in pediatric eye care are you most excited about right now?

One of the most exciting developments is myopia control strategies, including low-dose atropine therapy and specially designed optical lenses that slow progression. Advances in pediatric imaging technology also allow earlier and more accurate diagnosis, even in very young children. Increasing awareness of preventive eye care among parents and schools is also a very positive development in protecting children’s long-term vision.

Dr. Ola Alsaed

Dr. Alsaed’s areas of specialization include paediatric ophthalmology, squint (strabismus), and general ophthalmology. She is a member of the Royal College of Surgeons of Edinburgh and a Fellow of the International Council of Ophthalmology, reflecting her commitment to the highest professional and clinical standards in ophthalmic care.