Recognizing poor eyesight in children - does my child see correctly?


It is estimated that one in ten children in Germany cannot see properly. For learning to see correctly and for development, it is important that both of the child's eyes function properly. Uncorrected poor eyesight can have serious effects on eye and brain development. But it is also important for social life and later school and professional life to be able to see properly. Under certain circumstances, it can be very difficult to discover poor eyesight in your own child.


The most common causes of poor eyesight in children are structural defects in the eye. Here, the images from the environment are not recorded correctly and / or are not put together correctly in the brain. These construction defects include farsightedness (Hyperopia), Myopia (Myopia), Astigmatism (astigmatism) and squinting (Strabismus). One eye or both eyes can be affected and various errors can occur together.

Read more about this under

  • Farsightedness in children
  • Myopia in children
  • Astigmatism in babies
  • What to do when children squint?

Color vision disorders, such as red-green poor eyesight, reduced twilight vision and night blindness are less common. In these disorders, certain cells in the retina are defective. Lens opacities such as cataracts can also occur in children.

In premature babies, especially before the 32nd week of pregnancy, the risk of premature retinopathy increases. In this case, the vessels in the retina grow and proliferate at an above-average rate and can lead to strabismus, myopia and bleeding. The retina can rarely become detached and lead to blindness.

Read more about this under Retinopathy of premature infants

Red-green poor eyesight in children

Red-green poor eyesight or blindness is always congenital. Because it is inherited through the X chromosome, it affects ten times as many men as women. The result is that the gene for the colors green or red is incorrect or not present at all, so that these colors cannot be recognized by the uvula in the retina. This ametropia is often not a hindrance in everyday life. In later life only certain professions, such as police officer or pilot, may not be practiced at all or only after a special ophthalmological examination. Red-green poor eyesight cannot be treated and does not change in the course of life.

Signs of poor eyesight in children

The following things can be signs of poor eyesight in small children: squinting, trembling eyes, noticeably large or watery eyes, rubbing in the eyes, grimacing, constant tilting of the head, rigid pupil when exposed to light, whitish pupils or yellowish pupils when exposed to direct light, or a fear of light clouded cornea. Rolling the eyes without looking at something, reaching past objects or not fixing the eyes of objects or people can also indicate poor eyesight.

In older children, the signs are a little more diffuse. Concentration problems, headaches, clumsiness, balance disorders and difficulty reading or arithmetic can be caused by poor eyesight.

Concomitant symptoms

Symptoms that occur together with visual impairment are often caused by the child's desire to compensate for the ametropia. Tension can arise from holding the head at an angle, or headaches from increased effort when looking.
With older children of kindergarten and elementary school age, concentration disorders, poor reading and spelling, arithmetic problems and clumsiness are also often noticeable. These accompanying symptoms are causally attributable to the poor eyesight. If the child suffers from cataracts, this is usually noticeable as a bright spot in the dark pupil.

How can you tell if you have poor eyesight in children?

Early detection of visual disturbances can already take place during the U-examinations. The pediatrician looks for abnormalities, which the ophthalmologist can then check if necessary. In the various U-examinations, certain focal points are in the foreground. For example, abnormalities in the eyeballs, eyelids and pupils are checked for U2.
During the further U-examinations, attention is paid to whether the child is following an object and how the pupils react to light. In addition, an examination with the so-called Ophthalmoscope, in which the child's eyes are shined from afar and close up and which can primarily show uneven ametropia, severe nearsightedness or farsightedness, strabismus and clouding. If an ametropia becomes apparent during the examinations, further tests can be carried out by the ophthalmologist. Visual acuity can be measured with the help of samples and spatial and color vision can be checked. A variety of special tests are available for the individual ametropia.

Read more about this under

  • Medical check-up in children
  • U2 investigation

When does my child need glasses?

Visual impairments in children should be treated before the age of four. Up to this point the child learns to see and the brain develops the necessary areas and connections for visual acuity and spatial vision. Many children are farsighted in their early years. This is because the eye is still too short, but in most cases this corrects itself over time. However, if the value is above +2.5 diopters, glasses are required. Even if the child complains of complaints, such as headaches, glasses should be worn even if the values ​​are lower. Constant squinting must also be treated with glasses or masking one eye to prevent preferential treatment of one eye and blindness in the other.

With astigmatism and nearsightedness, glasses are always necessary. Eyeglasses that see differently, for example a myopic and a normal-sighted eye, should be treated with glasses as early as possible.

What can I do myself?

It is important to have your eyes checked early if you suspect poor eyesight. This can be indicated when the child stumbles frequently, reaches past objects or holds the picture book very close to their face. Even little things that make parents suspicious should be checked by an ophthalmologist. It is therefore important to watch your child carefully. Eye tremors, clouded corneas or discolored pupils should also urgently lead to a doctor's visit. If the child has risk factors such as premature birth or if there are hereditary eye diseases in the family, a visit to the doctor from the age of six months makes sense, even if there are no abnormalities.


If a visual impairment is not recognized early, it can lead to difficult or irreparable damage from primary school age. In the case of one-sided ametropia, the better eye can take over the visual function and the worse eye gets worse and worse. The associated areas in the brain develop worse and the visual defect can no longer be corrected. Spatial 3D vision is then also restricted. However, bilateral weak eyesight can also lead to overexertion and thus to headaches and concentration problems. The earlier a poor eyesight is treated, the better the prognosis that the eyes can develop properly.