Signs Your Child Might Need Glasses (and What to Do Next)

Observable signs worth noting

The following behaviors may suggest a child is struggling to see clearly and deserve a conversation with the pediatrician or an eye care provider 1Ref 1American Academy of Pediatrics / HealthyChildren.org (2024).Vision Screenings for Babies & Children.AAP screening schedule at well-child visits; preschool comprehensive exam recommendation; limits of chart-based screening; permanent vision loss risk if untreated:

• Squinting: Squinting narrows the amount of light entering the eye and can temporarily sharpen focus — children who squint frequently when looking at a board, TV, or books may be trying to compensate for blurry distance or near vision.
• Sitting very close to the television or holding reading material close: Classic sign of nearsightedness, though holding things close can also occur with other refractive patterns.
• Tilting or turning the head to see: Can indicate that one eye sees better than the other, or that there is an issue with eye muscle balance.
• Frequent eye rubbing outside of tiredness: Sometimes a sign of eye fatigue or strain, which can accompany refractive errors.
• Complaints of headaches, especially after reading or screen time: Eyestrain from uncorrected farsightedness or astigmatism can cause end-of-day headaches, particularly in school-age children.
• Covering one eye to see better: A child who habitually closes or covers one eye may be compensating for double vision or a significant difference between the two eyes.

What the school screening does and does not catch

School-based vision screenings and the brief checks done at the pediatrician's office are valuable — they catch many moderate to significant refractive errors, especially nearsightedness. But they are screening tools, not comprehensive exams. They may miss mild farsightedness, early amblyopia, intermittent eye alignment problems, and conditions that do not affect standard letter-chart acuity 1Ref 1American Academy of Pediatrics / HealthyChildren.org (2024).Vision Screenings for Babies & Children.AAP screening schedule at well-child visits; preschool comprehensive exam recommendation; limits of chart-based screening; permanent vision loss risk if untreated.

A failed vision screening is a clear signal to schedule a full exam. But a passed screening is not a guarantee that no vision issue exists, particularly if a parent has ongoing concerns 1Ref 1American Academy of Pediatrics / HealthyChildren.org (2024).Vision Screenings for Babies & Children.AAP screening schedule at well-child visits; preschool comprehensive exam recommendation; limits of chart-based screening; permanent vision loss risk if untreated. Some eye problems can cause permanent vision loss if left untreated in childhood, making regular screening critical.

Types of vision problems glasses most commonly address

Myopia (nearsightedness): Difficulty seeing at a distance; close-up is clearer. Often becomes noticeable in the school years and is the most common reason for glasses in children.

Hyperopia (farsightedness): Some degree of farsightedness is normal in young children; the eye often accommodates well enough that no glasses are needed. Significant hyperopia, however, can cause eyestrain, difficulty sustaining focus during reading, and in some children drives eye crossing (accommodative esotropia) 2Ref 2Bhatt AK, Bhatt A, Bhatt T (2024).Detecting vision problems in children.Amblyopia treatment most effective when caught early; farsightedness and accommodative esotropia; risk factors warranting early specialist referral.

Astigmatism: Irregular curvature of the cornea causes blur at multiple distances. Can exist alongside myopia or hyperopia.

Amblyopia (lazy eye): Reduced vision in one eye due to abnormal visual development in early childhood. Treatment is most effective when caught early, which is one of the main reasons comprehensive preschool eye exams are recommended 2Ref 2Bhatt AK, Bhatt A, Bhatt T (2024).Detecting vision problems in children.Amblyopia treatment most effective when caught early; farsightedness and accommodative esotropia; risk factors warranting early specialist referral.

When and how to get a full eye exam

The AAP recommends vision screening at every well-child visit, with comprehensive screenings recommended at ages 3–5 before starting school 1Ref 1American Academy of Pediatrics / HealthyChildren.org (2024).Vision Screenings for Babies & Children.AAP screening schedule at well-child visits; preschool comprehensive exam recommendation; limits of chart-based screening; permanent vision loss risk if untreated. A comprehensive exam performed by an ophthalmologist or optometrist experienced with children includes dilating the pupils to accurately measure the eye's refractive state — something a simple chart-based screening cannot do 1Ref 1American Academy of Pediatrics / HealthyChildren.org (2024).Vision Screenings for Babies & Children.AAP screening schedule at well-child visits; preschool comprehensive exam recommendation; limits of chart-based screening; permanent vision loss risk if untreated.

If a parent notices signs at any age, scheduling an exam sooner makes sense regardless of the last screening result. For children under three with apparent vision concerns or risk factors (premature birth, family history of amblyopia or strabismus, eye injury), referral to a pediatric eye specialist may be recommended earlier 2Ref 2Bhatt AK, Bhatt A, Bhatt T (2024).Detecting vision problems in children.Amblyopia treatment most effective when caught early; farsightedness and accommodative esotropia; risk factors warranting early specialist referral.