How to Tell If Your Child Needs Glasses

Vision problems are very common and the treatment is usually straightforward. However, untreated vision problems can lead to challenges in school, delayed development, and even blindness. Regular vision screenings are an important component of your child’s healthcare. During childhood the eyes are growing and developing in amazing ways, so identifying and treating vision problems early is the best way to support your child’s eye development.

Why Eye Health Is Important for Children

Our five senses provide very valuable information to the developing brain and body. Many early child development milestones involve vision: recognizing a parent’s face (face recognition), playing peek-a-boo (object permanence), or learning to read (reading skills). Eye health is connected to healthy development, positive school outcomes, safety, and quality of life. Assessment of your child’s vision development milestones is an important part of their regular healthcare.₁

Types of Vision Problems that are Common for Children

Although many children have healthy vision development, many children may also develop common vision problems like refractive errors, such as myopia, hyperopia and astigmatism, or strabismus, or a turning of the eyes. Globally, “uncorrected refractive errors are the leading cause of visual impairment in school-age children (5–18 years)”.₂

Most vision problems are very treatable. Regardless of the type of visual impairment, early detection of vision problems can ensure that children receive the health care and support they need to thrive in childhood and beyond. 

Common Vision Problem Corrections for Children

Many vision problems can be corrected. All children with refractive errors, strabismus, or amblyopia need to see an eye doctor to determine the correction or care that will be required to address their vision problems. Most common vision problems can be corrected with glasses. In New York State, vision care and eyeglasses are covered by Medicaid. Other treatment or corrective options may be available or suggested for your child based on their needs._7,8

While the vision problem may not “go away”, correcting or treating vision problems during childhood can improve long-term quality of life and prevent the development of additional vision problems. If left untreated, refractive errors can lead to amblyopia, strabismus, and vision loss._5,9,10

Common Signs Your Child May Need Glasses

Squinting or Tilting Their Head

Children with a refractive error might squint or tilt their heads to try to see better. Squinting or tilting their head could be signs of myopia or astigmatism and may mean your child is struggling to see clearly at a distance._4,11

‍Sitting Too Close to Screens or Holding Books Too Close

Children with a refractive error may get very close to screens or books because it’s easier for them to see things up close than far away. Sitting too close to screens or holding books too close could be signs of myopia or astigmatism and may mean your child is struggling to see clearly at a distance._4,11

‍Frequent Eye Rubbing or Complaints of Headaches

Children with a vision problem may complain of headaches or may frequently rub their eyes. When a child has hyperopia, myopia, or has difficulty focusing on close objects with both eyes, they may complain of headaches especially while trying to read books or when looking at a screen up-close. Other reasons a child may have headaches or rub their eyes include allergies, foreign body in the eye, head injury, stress, or migraines._12,13

‍Avoiding Reading

Children with a vision problem may avoid reading. When a child has hyperopia, myopia, or has difficulty focusing on close objects with both eyes, they might avoid reading, homework, or crafts because their vision makes it uncomfortable—even if they can’t explain why.₁₄

‍Difficulty Focusing in School

Children with a vision problem may have challenges in school. Learning environments often include a lot of visual stimuli and require visual attention like reading a book, writing on a smartboard, and even practicing athletics. For children with vision problems, these visual activities may cause pain, they may seem less engaging, they may be uncomfortable, it may even feel scary. A child may not even know that their vision is causing their difficulties and these behaviors could be mistaken for a learning problem._1,14

A child may not be able to communicate their vision challenges or they may not even notice that their vision is not clear. This is one reason why regular screening is important. By getting a basic vision test each year you may be able to identify vision problems early.₉

Between vision tests a parent may notice changes in their child’s behavior that may signal a vision problem. If you notice any of these behaviors in your child and think it may be due to vision problems reach out to your pediatrician or schedule a visit with an eye care provider, such as an optometrist or ophthalmologist.

When to Schedule an Eye Exam for Your Child

Vision screening for healthy eye development is an important part of your child’s regular health care. Some children will only need a basic vision screening that can completed during their regular check-up. Basic vision screenings may be completed by a pediatrician, a family health doctor, at school, or in the community. Some children may need a more detailed assessment. In these cases they will be referred to an optometrist or ophthalmologist for a comprehensive eye exam. You do not need to wait for an annual physical to assess your child’s vision. If you notice that your child may be experiencing vision problems, reach out to your pediatrician or schedule a visit with a qualified eye care provider.₁₅

As a child ages, the vision test will change to focus on each new development milestone. 

During a child’s newborn and toddler years:

Their primary care provider may check their eyes for a red reflex, blink and pupil response, healthy eye alignment and movement, and amblyopia.₁₅ For more information on your young child's vision milestones and what to look for at each stage check out this booklet by Prevent Blindness.

Between ages three to five:

Once a child is old enough to read an eye chart, a primary care provider may check their visual acuity. A visual acuity test measures how clear a child’s vision is to assess for refractive errors.₁₅

Ages five to eighteen:

Once a child turns 5 they should have a visual screening every one to two years. A person’s vision tends to be fully developed by the time they reach their 20’s. It is important to identify vision problems if they arise during childhood so they can be treated early._16,17

Accessible and Affordable Vision Screenings at CBWCHC

The Charles B. Wang Community Health Center offers high-quality primary eye care and pediatric care to meet your child’s needs.

If your child requires an eye exam or is referred to an optometrist, the Health Center's optometrists provide comprehensive primary eye care to patients of all ages including eye exams and prescriptions for glasses. You can also schedule a basic vision screening for your child with one of our primary eye care providers without a referral. Charles B. Wang Community Health Center offers primary eye care five days a week in Flushing, Queens and twice a week in Manhattans Chinatown. Learn more about our primary eye care providers and find a location that is convenient for you.

Your child may also receive their basic vision screening during an annual physical or during a pediatric visit. Charles B. Wang Community Health Center pediatricians provide healthcare to patients from birth up to 21 years of age. We offer pediatric care at three of our locations in Manhattan’s Chinatown and Flushing, Queens. To learn more or to schedule an appointment, explore our pediatric provider’s profiles or give us a call.

Charles B. Wang Community Health Center accepts most major medical and vision insurance plans. We also offer fee discounts based on family size and income. Our providers speak a variety of languages including, English, Mandarin, and Cantonese, so you can feel comfortable navigating your child’s eye care in the language you prefer. Services are provided regardless of a patient's ability to pay or immigration history.

FAQ

My child has Medicaid but doesn’t have a specific vision insurance. Can they still access vision screenings?

In New York State, vision care and eyeglasses may be covered by your child’s Children’s Medicaid or Child Health Plus (CHP) plan.₈ Contact your health plan provider to learn more about which vision services are covered by your plan.

At the Charles B. Wang Community Health Center we accept most major health insurances and offer a sliding fee discount program for individuals who are underinsured or uninsured.

What if my child needs glasses?

Glasses are a very common treatment for children with refractive errors. Contacts or surgery are less common treatment options for children._5,11,18,19

When a child is prescribed glasses they will receive a prescription which can be confusing to read. Three important columns are “SPH”, “CYL”, and “Axis”.₂₀

• The column “SPH” means “sphere”, this number measures the amount that the lens is correcting your child’s vision. The plus sign (+) means their glasses are correcting for hyperopia and the minus sign (-) means their glasses are correcting for myopia.
• The column “CYL” means “cylinder”, this number measures the amount that the lens is correcting for your child’s astigmatism. When your child has an astigmatism they will have a number in the “CYL” column and the “Axis” column. The “Axis” column identifies where the astigmatism lines up on the eye.₂₀

Some children will struggle to adjust to glasses, especially if they have an astigmatism. However it is important to encourage your child to wear their glasses. Selecting well-fitting glasses is an important way to make sure glasses are comfortable for children to wear. You may also be able to add a strap or other device to hold their glasses in place._7,21

How can I help prevent nearsightedness (myopia) for my child?

Myopia is a very common vision problem, and the number of children developing myopia is growing. Developing myopia may be genetic, so a child is more likely to develop myopia if their parent also has myopia._1,11

One way to reduce the risk of myopia for your child is to encourage balance between indoor and outdoor activities. In general, the likelihood of developing myopia decreases when a child spends more time outdoors and increases when a child spends more time on “near” activities like reading, writing, or close screen time. Spending more time outdoors during childhood (while the eyes are still growing) can protect a child from developing myopia even if they have a genetic predisposition. Other treatments, such as orthokeratology contact lenses and atropine drop therapy, have also been found to reduce the progression of myopia. You should discuss the most appropriate treatment for your child with your eye care provider._19,22,23,24