Refractive error
Most children are born slightly far-sighted (or hyperopic). Being hyperopic means the eye has to focus to see well at a distance as well as to see close up. As children grow they normally lose some of their original hyperopia. However, some children are born with more than the normal amount of hyperopia, and need glasses to help them see both far away and at near distances. Also, sometimes children need glasses to correct astigmatism or myopia (near-sightedness).
It is important for any significant refractive error (myopia, hyperopia, or astigmatism) to be corrected in children so that the connections between the eye and the brain form properly and they learn to see clearly from an early age. If children are deprived of clear vision when young, they will not have the ability to see clearly later in life, even if they wear the appropriate glasses then.
Crossed eyes (strabismus)
Many children have crossed eyes (strabismus) for various reasons. The crossed eyes are frequently evident shortly after birth, or they may develop in the pre-school years. Sometimes the crossing can be alleviated with appropriate glasses. It is important for the child to have an ophthalmologic examination to ensure that a brain problem is not contributing to their eyes crossing. The ophthalmologic examination should also evaluate for any ocular preference as the child may stop developing good vision in the eye that crosses more frequently. Sometimes patches are used to cover the preferred eye, thereby forcing the child to use the less preferred eye. Frequently strabismus surgery is recommended to help straighten the eyes.
Types of strabismus include esotropia (eyes crossing inward), exotropia (eyes drifting outward), and hypertropia or hypotropia (eyes misaligned vertically). These are associated with different causes, and have different treatments, which a pediatric ophthalmologist is trained to evaluate and manage.