5 common childhood eye diseases

Ophthalmologist at the Pretoria Eye Institute, Dr Hamza Tayob, provides insight into common childhood eye diseases, and how to spot them.


Your child’s eyes are more than the windows to his soul. He needs them to explore the world around him. Unfortunately, there are many diseases and conditions that can put his eye health at risk.

We examine the five most common childhood eye diseases that can affect your child’s vision:

ALSO SEE: Your child’s eye development from birth to three years


Amblyopia, also known as lazy eye, occurs when one eye does not receive as clear a picture as the other. The most common causes are strabismus, refractive error (incorrect focussing power), ptosis (droopy eyelid) and cataract (clouding or opacity in the lens).

Signs and symptoms of a lazy eye include:

  • An eye that wanders inward or outward
  • Eyes that appear to not work together
  • Poor depth perception
  • Squinting or shutting an eye
  • Head tilting
  • Abnormal results of vision screening tests.

Treatment options include patching and/or glasses. If treatment is started at an early age, vision can be improved significantly.

ALSO SEE: 7 signs that your child needs an eye examination 

Epiphora (watery eyes)

Epiphora, more commonly referred to as watery eyes, is when there is excessive tear production or blocked tear ducts.

This can happen for a number of reasons:

  • Overproduction of tears
  • Infection
  • Blocked tear ducts

Signs and symptoms include:

  • Redness
  • Enlarged, visible blood vessels
  • Soreness
  • Sharp pain
  • Eyelid swelling
  • Blurred vision
  • Light sensitivity.

When treating watery eyes, you need to treat the underlying condition. Treatment options may vary from a conservative approach to surgical correction. Your doctor will give you the best course of action.

Chalazion (swelling of the eyelid)

Chalazion is a small swelling of the eyelid caused by a blockage in the glands, which could be accompanied by redness and yellowy ooze. A child could have a number of these swellings on an eyelid at any one time. The condition can affect one or both eyes.

Signs and symptoms may include:

  • A small bump which can usually be felt in the eyelid
  • A gradual swelling of the eyelid
  • Discomfort in the eye or difficulty with seeing if the chalazion is large. This condition is usually not painful.

Consult your family doctor who will suggest initial treatment. If there is no improvement after three or four months, an eye specialist should be consulted.

Conjunctivitis (pink eye)

Pink eye can be either viral or bacterial. But, both infections are very contagious. Pink eye can also be caused by a non-contagious allergic reaction. Either way, the eye appears red or pink due to inflammation of the thin membrane covering the inside of the eyelids, and the white part of the eye. The eye tears, emits a discharge, or both, and the condition is generally itchy and uncomfortable.

Signs and symptoms of conjunctivitis:

  • A red or pink eye (or both eyes)
  • Redness behind the eyelid
  • Swelling of the eyelids, making them appear puffy
  • Excessive tears
  • A yellow-green discharge from the eye which dries when your child sleeps causing crusting around the eyelids
  • A dislike of bright lights (photophobia)
  • A gritty feeling (like there is sand in the eye
  • Itchiness of the eyes and eye rubbing.

Children with contagious pink eye need to stay home from school or return home to avoid infecting others. The condition usually resolves itself within three to seven days. Once the tearing and discharge has stopped, the child can return to school.

ALSO SEE: Is my child too sick for school?

Strabismus (squint)

Strabismus happens when the eye points in different directions all the time, or sporadically. It may be present at birth or appear later. Either way, the vision in the affected eye will not develop normally and the child will not outgrow the condition.

Signs and symptoms of Strabismus:

  • During the first 3 months of life, the eyes wander outward all the time, or they cross inward
  • After 3 months of age, one or both of the eyes wander out or cross in
  • Your child may tilt his head in order to effectively line up his eyes to use them together or he may squint one eye, especially in bright sunlight, to block out a double image resulting from the misaligned eyes pointing in different directions.

Treatment is aimed at establishing sound vision and coordination in both eyes as well as improving appearance. The earlier treatment starts, the more effective it will be.

Treatment options include:

  • Glasses
  • Patching
  • Exercises
  • Surgery
  • A combination of the above.

Prevention is better than cure

Routine medical eye exams for kids include the following:

  • Newborn babies should be checked for general eye health by a paediatrician or family physician in the hospital nursery after birth.
  • High-risk newborn babies (including premature infants), children with a family history of eye problems and those with obvious eye irregularities should be examined by an eye specialist.
  • In the first year of life, all infants should be routinely screened for eye health during check-ups with their paediatrician or family doctor.
  • Around the age of three and a half years, kids should have eye health screenings and visual acuity tests (tests measuring sharpness of vision) with their paediatrician or family doctor.
  • Around age five, kids should have their vision and eye alignment checked by their paediatrician or family doctor. If any of these tests are failed, an eye specialist should be consulted.
  • After age five, routine screenings should be done regularly, especially if symptoms such as squinting and frequent headaches occur.
  • Kids who wear prescription glasses or contact lenses should have annual check-ups with an eye doctor to monitor vision changes.

Red flags to watch out for

Signs that your child may have vision problems include:

  • Constant eye rubbing
  • Extreme light sensitivity
  • Poor focussing
  • Poor visual tracking (following an object)
  • Abnormal alignment or movement of the eyes (after six months of age)
  • Chronic redness or tearing of the eyes
  • A white, instead of a black pupil.

Further symptoms in school age children include:

  • Being unable to see objects at a distance
  • Having trouble reading the blackboard
  • Squinting
  • Difficulty reading
  • Sitting too close to the TV.
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