Childhood Vision: What the Research Tells Us

Childhood Vision: What the Research Tells Us

Overview

Vision problems are common among children.
While a nationwide study of vision problems in children has not been conducted in over 30 years, the most recent NHIS study shows vision problems are common in children, with an estimated 13.5 million children ages 0 – 17 affected.1,2

Many preschoolers have treatable vision problems.
Among preschool children, ages 0 – 4, vision problems affect approximately 2.4 million (10.5%) children, according to a 1983 government study.3,4

Rates of vision problems rise as children get older.
Among school-aged children ages 6 to 11 years old, an estimated 5.3 million (21.5%) have a vision problem. Rates continue to rise as children get older, with an estimated 24% of 12 – 17 year olds exhibiting some type of vision problem. 5,6

Serious vision problems affect some children.
Approximately 453,600 children (less than 1%) 0 – 17 years old suffer from serious vision impairment, including blindness in one or both eyes, or other uncorrectable low vision problems. 7,8,9


Common Eye Problems in Children
  • Amblyopia (2–3% of children)—Known as "lazy eye." Reduced vision from lack of use in an otherwise normal eye
  • Astigmatism—Irregular corneal shape that may result in blurred vision
  • Blepharitis—Swollen eyelids
  • Cataract—Cloudy lens that affects focusing
  • Conjunctivitis—Known as "pink eye." Reddening of the white part of the eye usually caused by a viral, bacterial infection, or allergy
  • Corneal Abrasion—Known as "scratched cornea"
  • Glaucoma—Elevated eye pressure that can lead to blindness
  • Hyperopia—Known as "farsightedness." Objects that are near are unclear
  • Myopia (most common vision problem among school-age children)—Known as "nearsightedness." Objects that are far away are unclear
  • Pseudostrabismus—Appearance of crossed eyes, yet the eyes are truly straight
  • Ptosis—Known as "droopy eyelids." The eyelids do not open as they should
  • Strabismus (4% of children)—Misaligned eye(s) that either turn inward ("crossed eyes") or outward.

American Academy of Pediatrics. Common vision and eye problems. 2000.
Medical Library Online. Available at www.medem.com.

Early detection is important for some vision problems.
Optimum treatment for eye conditions such as lazy eye, crossed eyes or eyes that turn outward, require early detection, usually well before age 5, otherwise irreversible visual deficits, including blindness, may occur. 10,11


Vision Problem Warning Signs
  • Eyes turning inward (crossing) or outward
  • Squinting
  • Headaches
  • Not doing as well in schoolwork as before
  • Blurred or double vision
  • Losing place while reading
  • Avoiding close work
  • Holding reading material closer than normal
  • Tending to rub eyes
  • Eyes tiring when reading or doing schoolwork
  • Turning or tilting head to use one eye only
  • Making frequent reversals when reading or writing
  • Using finger to maintain place when reading

  • Consistently performs below potential

US: Child Health Guide. Publication No. APPIP 98–0026. Current as of January 2003.
Harris P. Learning related visual problems in Baltimore City: A long-term program. JOVD. 2002; 33: 75–115.
American Optometric Association. Children’s vision: school-age vision. Available at www.aoa.org.

Vision problems vary slightly between boys and girls.
Rates of eye conditions for preschool boys and girls are similar at 10.3% and 10.7%, respectively. However, as children get older, the rate of vision problems in boys is 3.5% higher (23.2%) than for girls (19.7%) for the 6 – 11 age group. The difference continues into the 12 – 17 age group with rates for boys at 26.1% and girls at 22.5%.12

Income may make a difference in correcting identified vision problems.
According to several studies, income may make a difference in correcting vision problems. Children in families with incomes greater than 200% of the federal poverty level were more likely to have corrective lenses (29.9%) than those with incomes less than 200% of the federal poverty level (19.3%).13,14

Sports and toys are leading causes of eye injuries in children according to hospital reports.
In 2000, an estimated 18,060 sports and recreation-related eye injuries to children under 14 were reported. 15 The five most commonly reported sports activities associated with eye injuries included baseball, basketball, swimming, bicycling, and football. Playing with toys caused another 9,000 eye injuries to children under 14. Among the most common toys cited as causing eye injuries were toy weapons, bicycles, and balloons. 16

References

  1. Ganley JP and Roberts J. Eye conditions and related need for medical care among persons 1–74 years of age: United States, 1971–1972. Vital Health Stat 11(228). 1983. Page 21, Table 1.
  2. America’s Children 2003. Child population: Number of children under age 18 in the United States by age, selected years 1950–2000 and projected 2002 through 2020. Table POP1. U.S. Census Bureau 2001 estimates based on population projections for 2001–2020 that are unpublished. Available at http://www.childstats.gov.
  3. Ganley JP, op.cit.
  4. America’s Children 2003, op. cit.
  5. Ganley JP, op.cit.
  6. America’s Children 2003, op. cit.
  7. National Center for Health Statistics. Current Estimates from the National Health Interview Survey: United States. Vital Health Stat 10(200). 1996. Table 57.
  8. America’s Children 2003, op. cit.
  9. Centers for Disease Control and Prevention. National Center on Birth Defects and Developmental Disabilities. Vision Impairment: What is vision impairment? Available at http://www.cdc.gov/ncbddd/dd/ddvi.htm. Accessed April 22, 2004.
  10. Cross AW. Health screening in schools. Part I. J Pediatr. 1985;107(4):487–494.
  11. U.S. Preventive Task Force. Screening for visual impairment in children younger than ages 5 years: Recommendation statement. May 2004. Agency for Healthcare Research and Quality, Rockville, MD. Available at  http://www.ahrq.gov/downloads/pub/prevent/pdfser/visualser.pdf
  12. Ganley JP, op.cit. Table 1.
  13. Kemper AR, Bruckman D, Freed GL. Prevalence and distribution of corrective lenses among school-age children. Optom Vis Sci. 2004;81:7–10.
  14. Kemper AR, Cohn LM, and Dombkowski KJ. Patterns of vision care among Medicaid-enrolled children. Pediatr. 2004;113(3):e190–196.
  15. American Academy of Pediatrics. American Academy of Ophthalmology. Policy Statement: Protective eyewear for young athletes. Pediatr. 2004;113(3):619–621.
  16. National Injury Information Clearinghouse. U.S. Consumer Product Safety Commission/ Directorate for Epidemiology. Product Summary Report from the National Electronic Injury Surveillance System (NEISS). All products eye injuries CY 2002. Report generated April 30, 2004.

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