I had a young boy in for an eye exam today, booked in because he had failed his school vision screening. When his mother booked the appointment, I got the impression that she thought that his eyes were fine, except for the fact that he has a squint, “but he has always had a squint.”
Any optometrist’s immediate thought would be that a squint would be an obvious fail on a school screening, as squints are not normal. Some squints might not be easily detected at a screening- sometimes squints can be very difficult to detect without experience, but what is detected is the lazy eye which usually results from the squint- if a child learns that they can see better with one eye than both together (as two misaligned eyes cause double vision, and confusion- an inability to tell which object is in the straight ahead position), eventually the brain might habitually ignore one eye, and it will become “lazy”.
A squint is not the only possible cause of a lazy eye – if there is a significant difference between the sharpness of the eyes, again the brain might ignore the blurred eye. This is less common than a squint as the cause of a weakness, but often there is no way the parents could possibly suspect that there might be an issue.
Lazy eyes need to be detected as young as possible (ideally they should be prevented)- even if the bad eye cannot be improved to the same standard as its fellow, any improvement which can be gained (usually quite quickly – as a young child) may prevent months or years of difficulty as an adult, who may be unable to work or drive if the good eye was damaged by accident or disease. Lazy eye treatment may also remove restrictions which might be imposed in certain career choices, such as those requiring Class 2 driving licences, and many of the forces.
I had reason to contact Meath County clinic about this young chap, and was informed that there was an approximate waiting list of at least 12, probably more like 18 months before he could be seen – this is unacceptable, as a problem like this will be much more difficult to fix by an age of seven. He will be 6 to 6 1/2 when he is eventually seen. There is no point in screening the vision of school children if there is no sensible referral pathway available for those who fail.
This post is just to mention to parents that even if you THINK you see your child’s eye turning (perhaps it may be more obvious when they are tired) or you suspect one eye is poorer than the other, you should get this checked out as soon as possible – it is not normal, it will not go away on it’s own, and it will almost always result in a poor eye if nothing is done to intervene. Children rarely complain about visual difficulty – they have no reference to know that having a poor eye is not normal.
Parents – it is up you you!