About vision impairment, low vision and blindness
Vision impairment can range from no vision – blindness – or very low vision to an inability to see particular colours.
Vision impairment can happen at any age. Some conditions might result in vision problems for only a short time, but most vision conditions in children stay the same throughout life. Other conditions get worse over time, resulting in poorer vision or blindness as children get older.
What is low vision?
Low vision is when your child can’t see all the things they should be able to see for their age. Your child might have low-to-no vision, blurred vision or loss of side vision. Or they might not be able to see some colours – this is called colour blindness.
What is blindness?
This is when a child is considered legally blind:
- They can’t see at 6 m what a child with typical vision can see at 60 m.
- Their field of vision is less than 20° in diameter (a person with typical vision can see 180°).
Causes of vision impairment
Babies might have vision impairment at birth. It can also happen later as a result of disease, injury or a medical condition.
The most common causes of vision impairment are:
- neurological conditions that affect the parts of the brain that control sight (cortical vision impairment)
- 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, toxoplasmosis and so on
- 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 vision impairment
Children with vision impairment might have typical-looking eyes. It might be something about a child’s behaviour or the way they use their eyes that makes you think there’s a problem with their vision.
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 vision impairment, you might notice they have trouble doing this.
Here are some other signs that a baby has vision problems:
- 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.
An older child might:
- hold things up close to their face
- say they’re tired or rub their eyes a lot
- turn or tilt their head or cover one eye when looking at things up close
- get tired after looking at things up close – for example, reading, drawing or playing handheld games
- seem to see better during the day than at night
- seem to have crossed or turned eyes or a squint
- seem clumsy – for example, they might knock things over or trip often.
Diagnosis of vision impairment
Getting a diagnosis is the first step to the right intervention, the earlier 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 work out what the problem is.
If your doctor doesn’t think there’s a problem but you’re still worried, it’s OK to get a second opinion.
If your child is old enough, you could ask them to do some drawings of common objects or people. You could take the drawings with you to show the doctors. This will give doctors an idea of how your child sees the world.
Effects of vision impairment
Vision impairment can affect many areas of children’s development, some of which you might not expect.
For example, your child might have extra challenges with:
- communicating – for example, your child might not see someone waving and smiling at them or not be able to make eye contact
- playing and socialising with others – for example, your child might be clumsy, not be able to read body language, get lost in a crowd or have trouble making friends
- talking – for example, your child might not point to objects, so the people nearby won’t name these objects, and your child will miss the chance to learn the names
- telling the difference between day and night
- sitting, crawling and walking – for example, your child might not try to move because they can’t see the interesting objects you put out for them
- learning to read and write
- playing – for example, your child might be afraid to touch certain textures or explore areas they can’t see.
Severe vision loss or blindness can mean that some parts of your child’s development and learning will be slower than for other children. For example, you might notice that your child is slower in learning to roll over, crawl, walk, speak and be social with others. Your child’s ability to do all these things should come with time.
Engaging your child to explore their environment using whatever vision they have – and linking their vision with their other senses – will help spark their curiosity about the world around them.
Early intervention for children with vision impairment
Early intervention is the best way to support your child’s development. 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 learn the most from the people who care for them and with whom they spend most of their time, so everyday bonding, play and communication with you can help your child a lot.
There are several specialists who are trained to work specifically with children who have severe vision loss. These might include orthoptists, physiotherapists, orientation and mobility specialists, occupational therapists, counsellors 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 with vision impairment
If your child has a confirmed diagnosis of vision impairment, your child might be able to get support under the National Disability Insurance Scheme (NDIS). The NDIS helps you get services and support in your community, and gives you funding for things like early intervention therapies, assistive technology or one-off items like guide dogs.
Looking after yourself and your family
Although it’s easy to get caught up in looking after your child, it’s important to look after your own wellbeing too. 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 vision impairment.
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.