Low vision and blindness: babies, children and teenagers

About low vision and blindness

Low vision and blindness is when the eyes can’t see all the things they should be able to see. For example, low vision and blindness might include:

little, low or no vision
blurred vision
loss of side vision.

Low vision or blindness can happen at any age. Most low vision or blindness in children stays the same. Occasionally it can get worse over time, resulting in poorer vision as children and teenagers get older.

In this article, we say ‘blindness’ or ‘low vision’ when we’re talking about the condition. We say ‘blind’ or ‘have low vision’ when we’re talking about people. This use of language is guided by consultation with experts, advocates and people with lived experience.

Causes of low vision and blindness

Low vision or blindness might be there at birth. It can also happen later as a result of disease, injury or a medical condition.

The most common causes of low vision and blindness are:

neurological conditions that affect the parts of the brain that control sight
genetic conditions like albinism and retinitis pigmentosa
illnesses that happen to some very premature babies or to babies that have particular problems during birth
conditions like paediatric glaucoma or cataracts and cancers like retinoblastoma
infections with particular viruses during pregnancy – for example, rubella, cytomegalovirus, sexually transmitted infection and toxoplasmosis
structural problems with the eyes that limit vision – for example, microphthalmia or anophthalmia
damage or injury to the eye, to the pathways connecting the eye to the brain, or to the visual centre of the brain.

Early signs and symptoms of low vision and blindness

Babies, children and teenagers who have low vision or are blind might have typical-looking eyes. It might be something about their behaviour or the way they use their eyes that makes you think they have low vision or blindness.

Most babies start to focus on faces and objects by 4-5 weeks of age. By about 6-8 weeks, most babies will start smiling at the familiar faces and things they see. But if a baby has low vision or is blind, you might notice they’re not doing this.

Here are other signs of low vision or blindness in babies:

Their eyes move quickly from side to side (nystagmus), jerk or wander randomly.
Their eyes don’t follow your face or an object.
They don’t seem to make eye contact with family and friends.
Their eyes don’t react to bright light being turned on in the room.
Their pupils seem white or cloudy rather than black – you might notice this in photos.
Their eyes turn in towards their nose or drift outwards towards the side of their face – this might happen sometimes or all the time.

Here are signs of low vision or blindness in older children and teenagers:

They hold things up close to their face.
They say they’re tired or rub their eyes a lot.
They turn or tilt their head or cover one eye when looking at things up close.
Their eyes get tired after looking at things up close – for example, after reading, drawing or playing handheld games.
They seem to see better during the day than at night.
Their eyes are crossed or turned, or they have a squint.
They seem clumsy – for example, they might knock things over or trip often.

If you’re worried about your child’s vision, it’s a good idea to take a video of their behaviour. You can show the video to doctors. This will give doctors an idea of how your child behaves in a non-clinical setting.

Diagnosis of low vision or blindness

Getting a diagnosis is the first step to the right intervention. The earlier the diagnosis, the better.

If you’re worried about your child’s vision, it’s a good idea to see a GP, paediatrician or optometrist to get your child’s eyes checked. The GP, paediatrician or optometrist can send you to a children’s eye specialist – a paediatric ophthalmologist. The ophthalmologist will examine your child and do tests to assess their vision.

If your doctor doesn’t think there’s a problem but you’re still worried, it’s OK to get a second opinion.

Effects of low vision and blindness

Low vision and blindness can affect many areas of childhood development, some of which you might not expect.

Here are examples:

Communication – your child might not see someone waving and smiling at them or not be able to make eye contact.
Interactions and friendship – your child might be clumsy, not be able to read body language, get lost in a crowd or have trouble making friends.
Play – your child might be afraid to touch certain textures or explore areas they can’t see.
Sleep – your child might not be able to tell the difference between day and night, which can make it difficult for them to get into sleep routines.
Movement – your child might not try to sit up, crawl and walk because they can’t see the interesting objects you put out for them.
Language – your child might not point to objects, so people nearby won’t name these objects, and your child will miss the chance to learn the names.
Literacy – your child might have delays in learning the skills they need for reading and writing.

Low vision and blindness can also affect many areas of adolescent development, including confidence, self-esteem, independence and responsibility , social participation and educational performance.

Very low vision or blindness can mean that some parts of your child’s development and learning will be slower than for other children and teenagers. For example, you might notice that your child is slower in learning to roll over, crawl, walk, speak and socialise with others. Your child’s ability to do all these things will come with time and support from health professionals.

Encouraging your child to explore their environment using whatever vision they have – and linking their vision with their other senses, like touch and smell – will help to spark their curiosity about the world around them.

Early intervention for children and teenagers who have low vision or are blind

Getting specialised help as early as possible after diagnosis is the best way to support your child’s development. This is called early intervention.

Early intervention includes therapies, education and other supports that will help your child reach their full potential.

Early intervention should also include helping you learn how to bond with your child and interact with them in ways that support their development. Children and teenagers learn the most from the people who care for them and with whom they spend most of their time, so everyday interactions with you, like play and communication, can help your child a lot.

There are several specialists who are trained to work specifically with children and teenagers who have low vision or are blind and the assistive technologies and devices that help them. They include counsellors, occupational therapists, orientation and mobility specialists, orthoptists, physiotherapists and special education teachers.

It’s good to see yourself as working in partnership with your child’s professionals. When you combine your deep knowledge of your child with the professionals’ expertise, you’re more likely to get the best outcomes for your child.

Learning to read and write in Braille is important for developing your child’s literacy. And introducing Braille early might help to support your child’s learning. There are library services that offer free Braille books and resources – for example, the Vision Australia Feelix Library and the Braille House Library.

Financial support for children and teenagers who have low vision or are blind

If your child has a confirmed diagnosis of low vision or blindness, your child might be able to get support from the National Disability Insurance Scheme (NDIS). The NDIS helps you access services and support in your community and gives you funding for early intervention therapies or assistive technology.

Looking after yourself and your family

It’s important to look after yourself physically, mentally, and emotionally. If you take care of yourself, you’ll be better able to care for your child.

Some agencies offer child and family counselling to help you work through the challenges and celebrate the triumphs that you’ll encounter in your life as the parent of a child with low vision or blindness.

Talking to other parents can be a great way to get support. You can connect with other parents in similar situations by joining a face-to-face or online support group.

If you have other children, they might have a range of feelings about having a sibling with disability. They need to feel that they’re just as important to you as your child with disability – that you care about them and what they’re going through. It’s important to talk with your other children, spend time with them, and find the right sibling support for them.

Low vision, blindness, legal blindness and vision impairment: terminology

There are various ways of describing people with low vision or blindness.

‘Low vision’, ‘blindness’ and ‘blind’ can include low vision, complete blindness and reduced or lack of side vision. Many people who have low vision or are blind prefer these terms.

‘Vision impairment’ also refers to a range of vision from low vision and restricted vision to complete blindness. Some organisations, specialists and other people use this term rather than ‘low vision’ or ‘blindness’, particularly during diagnosis. Many people who have low vision or are blind don’t like this term, because it suggests they’re damaged or have a deficit.

Legal blindness has a specific definition:

Your vision in both eyes is 6/60 – this means you can’t see at 6 m what someone with typical vision can see at 60 m.
Your field of vision is less than 20° in diameter, whereas a person with typical vision can see 180°.

Colour blindness is the inability to see some colours and affects 8% of the male population. It’s not related to low vision or blindness.