Many eye muscle problems are seen in young children. In the U.S., vision is checked annually in schools, but any vision problems should be diagnosed and corrected at a much younger age to avoid permanent problems with vision.
Vision therapy can be used to correct several common eye problems that occur in children.
Visual Milestones
It is normal for babies to look cross-eyed. This may be more about the shape of their faces--lacking a bridge on their noses--than an actual eye muscle condition. Similarly, it is not a sign of problems if in the early days of a child’s life, one eye drifts off from center a little, which is a sign they are training their eye muscles. But if these abnormalities appear beyond the first month or so, there may be a problem.
A baby can see when it is born, although it cannot make sense of the visual scene. In the first week, parents should notice the infant responding to bright light. By the end of the first week, the baby should be able to look clearly at the parent’s face. By the end of the first month, a baby should be able to look directly at the parent’s eyes. In the second month, the baby should be able to follow the parent as she moves around the room and will begin to look at his own hand. For small children, any problem playing with toys, recognizing objects or learning to write letters is grounds for a vision checkup.
Amblyopia
Amblyopia is commonly known as “lazy eye.” It is noticed when a child should be able to look directly at an object, yet one eye seems to drift off. It is very important that the child get an eye exam as soon as it is noticed, or it's possible for the child to favor one eye and never develop vision in the other eye. This is usually treated by putting a patch over the strong eye, forcing the weak eye to develop, then doing convergence exercises to force the eyes to work together.
Convergence Insufficiency
When focusing on a nearby object, if the child’s eyes are not uniformly turned in, they may have convergence insufficiency. This misalignment of the eye muscles can cause problems for the child in reading. It is not diagnosed until the child reaches reading age and is treated with eye-focusing exercises.
Strabismus
If the eyes do not appear to be in the same position when looking straight ahead, and the eyes appear to be crossed, or “wall eyed,” then the child may have strabismus. This is a condition of both eyes, as distinct from lazy eye. The eyes do not move together. A severe condition, it could cause double vision and a loss of depth perception. This disorder may be congenital or may be caused by a disease or disorder. In simple cases, it may be treated by glasses and exercises.
Nystagmus
Nystagmus is characterized by involuntary movement of the eye. This can be a normal condition, such as after spinning, the eyes will jump, both eyes together. But eyes shaking, or one eye moving alone, is an indication of a problem and can lead to loss of sight. Though it appears to be muscular, it can be caused by damage to the vestibular system, which tells the body if it is upright, or it can be due to damaged nerves.
