Eye problems in infancy and childhood are often overlooked because a child will not readily complain about his or her eyes. Early recognition and treatment are the keys to preventing permanent visual impairment. The following are important signs of vision problems to watch for in children:

DRIFTING EYE
Drifting of the eyes, known as strabismus, is common in childhood, occurring in 4 out of every 100 children. The eyes of a child with strabismus may cross or drift up or out. Without treatment, children will not outgrow this problem. Strabismus is treated with glasses or eye muscle surgery.

TEARING EYE
Six percent of all children are born with a blockage of the tear duct causing excessive tearing of the eye and crusting of the eyelashes. With massage of the tear duct and antibiotic drops, tearing usually resolves when the child reaches one year of age. For those who do not improve, surgery can be performed to open the tear duct.

SQUINTING
Squinting, favoring close objects, or headaches when reading may be caused by refractive errors:
Myopia (nearsightedness). A myopic eye cannot see objects in the distance clearly.
It is often first detected in the early school years when a child cannot see the blackboard or holds books too close.
Hyperopia (farsightedness). A hyperopic eye cannot see near objects clearly without extreme focusing. Uncorrected hyperopia can cause headaches, crossing of the eyes or permanently reduced vision.
Astigmatism is a condition where the vertical and horizontal portions of the eye focus at different points. This results in a blurred image at all distances.

ITCHY EYES
Frequent rubbing or blinking of the eyes may be a sign of ocular allergies. Children with this problem have red and itchy eyes that may last for weeks or months. Children with asthma or allergies are especially susceptible. New prescription eye drops can greatly improve this condition

DROOPY EYELID
Ptosis is a drooping of the eyelid that is caused by a muscle weakness. A droopy eyelid can impair sight and in some cases can cause permanent vision loss. Ptosis can be treated with surgery to strengthen the muscle that supports the eyelid.

FAILED VISION SCREENING
Amblyopia (lazy eye) is poor vision in an eye that did not develop normal sight during early childhood. Without treatment, children with amblyopia will never see well in one eye, even with glasses. Amblyopia is usually detected during a vision screening at school or at a pediatrician's office. Children with amblyopia usually show no obvious sign of the disorder, which emphasizes the need for early vision testing. Amblyopia responds well to patching treatment when diagnosed before 7 years of age. If your child fails a vision screening test, make sure that you bring him or her to a pediatric eye specialist as soon as possible.

WHEN SHOULD CHILDREN HAVE AN EYE EXAM?
The American Academy of Ophthalmology and the American Academy of Pediatrics recommend that all children have their eyes examined between their third and fourth birthday. Children with signs of vision problems or those with a family history of eye disorders (especially lazy eye) should be examined sooner.