It’s all in the eyes

We all know the importance of keeping our teeth clean and preventing dental decay, especially when it comes to children’s teeth – and if we didn’t already know, there are plenty of toothpaste and toothbrush adverts to remind us, on top of a strong emphasis on oral health education. Because of this, most families are aware of the need of dental care for their children as an essential element of healthy development.

Eye health, on the other hand, doesn’t always receive the same level of attention and understanding. Many adults, for example, may not be aware of the importance of regular eye exams for young children – especially since vision problems can sometimes go unnoticed until they are picked up at routine health checks or impact learning and development.

Education and awareness about the importance of eye health could help shift this perspective, encouraging more adults to take their children for regular optician visits just as they do for dental check-ups, so we’ve compiled a list of FAQs and their answers to help!

It’s recommended that children have their eyes tested from an early age – and certainly before they start school.

According to Vision Express, only 60% of schools now provide eye tests and those that do aren’t full eye tests or carried out by an eye care professional. This means that one in five children have an undetected eye problem that would’ve been picked up by an eye test.

Eye tests, or questions about concerns over children’s eyesight, form part of routine health and development checks between birth and age five:

• within 72 hours of birth as part of the newborn physical examination

• between six and eight weeks old

• around one year, or between two and two-and-a-half years

• around four or five years old (soon after they start school).

Outside of these routine checks, all children under the age of 16 – or 19 if in full-time education – are entitled to a free NHS eye test carried out at an opticians to check vision and eye health, and vouchers will be made available to purchase glasses if and when they’re needed. Parents/carers can arrange this themselves and don’t need to be referred.

Good vision plays a crucial role in a child's overall development. It’s essential for learning, social interactions, physical coordination and building confidence and self esteem.

Regular eye tests can help identify vision problems early. Many conditions, such as amblyopia (lazy eye) or strabismus (crossed eyes), can be more effectively treated if detected in early childhood.

There’s also a more serious, but thankfully rare, condition that generally affects children under the age of five: retinoblastoma, which is a rare form of treatable eye cancer. If any of the following signs are noticed, they must be checked out as soon as possible:

• a white pupil or reflection – a white reflection or pupil may be seen in a photograph where a flash has been used. Often, one eye will have the normal ‘red eye’, but the other may look white, yellow or orange. This may be seen in just one or many photographs of the child.

• no 'red eye' in flash photograph – in a photograph where one eye has 'red eye', which is normal, the other eye may look black or just look 'wrong'. This can also be a sign that something is not right.

• a squint – although a squint can be nothing more than just a squint, it can also be a sign of retinoblastoma, so it’s always worth having it checked out quickly to make sure.

Common signs that adults should look for include:

• squinting

• rubbing eyes frequently

• difficulty focusing on objects

• complaining of headaches or eye strain

• problems with hand-eye coordination

• sitting too close to the television

• eyes that appear to be looking in different directions.

Children who spend a lot of time looking at screens are also potentially at greater risk, as distance vision can be impacted. The long-term implications of untreated vision issues include academic struggles, low self-esteem, and poor social skills, so the earlier a problem is picked up, the better.

Early educators can play an important role in getting across to adults ways to take an active role in their children’s health and development. For example, suggesting a check-up prior to children starting school, and then scheduling regular check-ups and being observant of any changes in their child's vision.

In general:

• Share information on how eye tests for young children can be made fun and engaging, using games and colourful charts to help make the experience less intimidating.

• Build relationships with the local opticians, asking them to send you any new useful information and resources for the children and their families.

For the children:

• Ask your local opticians if they would like to visit the setting and talk to the children. You could also invite parents/carers and other adults in at this time.

• Plan a trip out with the children to visit the local opticians and follow-up with role play activities, stories and discussions when you return to the setting.

For parents and carers:

• Foster an open dialogue about health and wellness in the setting, encouraging families to ask questions and seek advice about children's vision.

• Organise workshops or share information that focus on the importance of vision health, covering topics such as developmental milestones and the impact of vision on learning.

• Use newsletters and emails to highlight the significance of eye exams, providing information about when and how often they should occur.

• Distribute brochures or pamphlets that detail the signs of vision problems, recommended screening ages, and local eye care providers.

By implementing some of these suggestions, early educators and settings can effectively motivate families to prioritise eye health and ensure children receive necessary eye tests, so every child has the opportunity for healthy vision.

Please also be aware that finding out that their child may need glasses/have a visual impairment can be upsetting, so take time to talk to families about how, by working together, you can be a part of the support for their child as they adjust to wearing glasses or needing additional help. Ensure that children see positive images of other children wearing glasses in the resources and images in your setting – even superheroes like Superman and Iron Man wear them!

• Signs your child needs glasses and how to help them keep their glasses on (CBeebies): bit.ly/U5_CBeebiesGlasses

• Information for parents of children with vision impairment (RNIB): bit.ly/U5_RNIBVision