Every parent wants what’s best for their child. Their health is our main priority. That’s why we watch them, observe how they behave and watch out for any symptoms indicating that something may be wrong.

It is due to that careful observation that many parents bring their children to our facility to see our Pediatric Ophthalmologist in NJ. They say their child is squinting or complaining about not being able to see clearly. Or perhaps the child is sitting very close to the TV or holding a book right in front of their nose.

All of these symptoms may indicate that the little patient may be having trouble with their vision. In a situation like this, the best thing a parent can do is to schedule an appointment with an children’s ophthalmologist.


How to tell if your child is at risk of developing eye problems?

Although eye conditions can happen to any child, there are certain risk factors which can increase the chances of such conditions developing. For example, children born prematurely, as well as those who have a family history of vision problems, are both statistically more prone to developing eye disorders.

Premature babies

If your child was born prematurely, he or she has a higher risk of developing certain eye problems such as strabismus and retinopathy of prematurity (ROP). ROP develops due to the abnormal growth of blood vessels in the retina. Without proper treatment, it can lead to permanent blindness.

Family history

Family history plays a role in vision problems. Some eye diseases can be determined genetically, even the most common eye disorders:


How to know if your child has vision problems?

A child who is having trouble with his or her vision often exhibits tell-tale signs. We recommend that you bring your child to our facility for an eye exam if you observe him or her:

  • Squinting
  • Tilting or turning the head
  • Having a poor coordination
  • Covering one eye
  • Having a short attention span
  • Rubbing the eyes



Squinting may be a sign that your child has an error of refraction. An error of refraction (EOR) means that the shape of the eye prevents the light from bending correctly and focusing on the retina. This results in blurry vision.

The types of EOR that can be found in children include:

  • Myopia (nearsightedness). 

Nearsighted children can see near objects clearly, but they struggle to see those that are far from them.

  • Hyperopia (farsightedness). 

Farsighted children can see far objects clearly but struggle to see things in proximity to them.

  • Astigmatism

Children with astigmatism cannot see things clearly regardless of their distance.

Children with EOR squint their eyes as a compensatory mechanism to have a clearer and sharper view of things around them. Other than squinting, you may find your child pressing the side of their eyes to put things in a better focus.

Squinting mimics the pinhole test used by ophthalmologists. If squinting or a pinhole test can improve the child’s vision, it means that he/she has a refractive error. If the vision doesn’t improve, the child might have a lazy eye.


Head tilting

Another way that children with vision problems can compensate is by turning or tilting the head to one side. Often, this is an unconscious response. Here are the possible reasons why they do so:

  • their eyes are not aligned properly (medically known as strabismus)
    • Hypertropia – one eye is turned upwards
    • Hypotropia – one eye is turned downwards
    • Esotropia – one or both eyes are turned inwards
    • Exotropia – one or both eyes are turned outwards
  • they have a better vision on one eye compared to the other (preferential gaze)
  • the muscles in their eyes are not balanced (muscle overaction, muscle underaction)
  • they are trying to ease eye strain (medically known as asthenopia)
  • they are trying to get a sharper focus and depth perception (stereopsis)


Poor hand-eye coordination

Some parents may associate this vision-related problem with clumsiness. Although some children are naturally clumsy, frequently falling over and bumping into things, this behavior can also be associated with eye conditions. When there is a problem with the eye muscles, your child may find it difficult to judge the distance of objects. Because of this, he or she may struggle to navigate around obstacles.


Covering one eye

If one of your child’s eyes has a vision problem, he or she may tend to cover the bad eye to prevent it from affecting the vision received by the good eye.

This response may be suggestive of amblyopia or lazy eye, a condition that develops very early in life wherein an eye doesn’t have a normal visual acuity. The lazy eye tends to receive fewer signals from the brain. If not corrected early, it can lead to a permanent loss of vision in the affected eye. The bad eye can also develop alignment problems.


Short attention span

Children with hyperopia or farsightedness have a short attention span for doing activities that require seeing things up close. Some farsighted children can also see objects up close, but they need to strain their eyes to do so. The effort needed to look at near objects may discourage them from doing activities like reading, coloring, and writing.


Eye rubbing

Even as adults, we tend to rub our tired eyes. The same is true in children. Rubbing the eyes may be a sign of eye strain caused by a problem in the eyes’ ability to focus.


Why is an eye exam important?

According to the Centers for Disease Control and Prevention (CDC), 6.8% of Americans diagnosed with an eye condition are younger than 18 years old. Early detection and prompt treatment are the keys to prevent disability associated with eye disorders. 


The importance of eye exams for children

Unlike adults, young children cannot fully communicate or express what they feel. Most often, they don’t even know that their vision is not normal, especially if they grew up with the condition. As parents, we need to be as observant as we can.

To diagnose eye conditions at an early stage, take your child to a pediatric ophthalmologist for regular eye exams. Vision screenings conducted by a pediatrician or a school nurse, although helpful, cannot detect many vision problems. Click here to learn the difference between a vision screening and an eye exam.

When a vision problem is left untreated, your child may find it hard to participate and excel in school activities. It can also delay their development. Moreover, the risk of developing ADHD is higher in children with vision problems, according to a 2016 study.

Only an eye exam performed by a child ophthalmologist can fully detect eye problems, even those in their early stage. The earlier the child is diagnosed and gets appropriate treatment, the better the outcome.


My child has no obvious visual problem. Does he/she still need an eye exam?

Even if your child doesn’t show any signs of there being an eye problem, you should bring them for an exam at the age of 3 or 4 for their first checkup. It’s very important as there are conditions that may only be treated at an early age.


What to expect during your child’s first eye checkup?

The eye examination includes the measurement of visual acuity, eye alignment, motility, refraction, and fundoscopy.

  • Visual acuity – To check if the child can make sense of letters, shapes, and details. It is measured using a Snellen Chart. In younger children who cannot read, our ophthalmologist may use a retinoscope.
  • Eye alignment and movement – To check if both eyes are coordinated and can look in the same direction at the same time.
  • Refraction – To check the retina’s ability to focus.
  • Fundoscopy or ophthalmoscopy – To examine the retina and the structures at the back of the eye.

If you are worried there may be something wrong with your child’s eyes, don’t hesitate to come in and see our doctors. There isn’t a ‘minimum’ age that the child needs to be in order for our pediatric ophthalmologist to be able to do an exam.


Get to know our pediatric ophthalmologists in NJ

Dr. Amy Lambert

Dr. Lambert, a board-certified pediatric ophthalmologist and strabismus surgeon, is the founder of Pediatric Eye Associates, LLC. Originally from New Jersey, Dr. Lambert attended public schools in Millburn before attending Bryn Mawr College in Pennsylvania, where she graduated magna cum laude.

After receiving her MD from Case Western Reserve University in Cleveland, Ohio, Dr. Lambert completed an internship at Yale University’s Department of Internal Medicine and a three-year residency in ophthalmology at New York University where, in her final year, she was selected to be the chief resident of the program. Following her residency, Dr. Lambert worked as a fellow in pediatric ophthalmology and strabismus at Indiana University, one of the nation’s top training programs for this subspecialty.


Dr. Rachel Bloom

Rachel Bloom, MD is a board-certified, fellowship-trained pediatric ophthalmologist. Originally from Long Island, New York, and a summa cum laude graduate of Brandeis University, Dr. Bloom received the prestigious Alumni Scholarship to attend medical school at Albert Einstein College of Medicine in New York. She completed her residency in ophthalmology and fellowship in pediatric ophthalmology and strabismus at the Albert Einstein College of Medicine, Montefiore Medical Center.


Where to find a child ophthalmologist near me?

If you are looking for a pediatric eye doctor, don’t hesitate to book an appointment with us at Pediatric Eye Associates.

Every child is different but all require the best quality of care, and we are here to provide just that. Don’t hesitate to come and see us – the sooner a vision abnormality is detected, the sooner we can start treating it.

We are always happy to answer any questions you may have. Contact us if you’d like to schedule an appointment at our center or if you have any questions regarding Pediatric Eye Associates. We are looking forward to seeing you soon!


The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.