By Raising Children Network
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Child's hands reading Braille ©

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According to the Australian Childhood Vision Impairment Register (ACVIR), 25% of registered children are Braille users, and 80% of registered children use some type of low vision aid.
Vision impairment is a term that covers many vision problems, as well as different kinds of vision loss including blindness. By working with health professionals, you can help your child with vision loss adapt, learn and achieve her full potential.

What is vision impairment?

Vision impairment means lots of different things. It can range from no vision – blindness – or very low vision to not being able to see particular colours.

Vision impairment can happen at any age. Most vision conditions in children will stay the same through their life. Some conditions might result in vision problems for only a short time, but others might get worse over time, resulting in much poorer vision or blindness as the child gets older. 

What is low vision?
Low vision is when your child can’t see all the things he should be able to see for his age. Your child might have low-to-no vision, blurred vision or loss of side vision. Or his eyes might not be able to see some colours – this is called colour blindness.

What is blindness?
A child is considered legally blind when she can’t see at 6 m what a child with normal vision can see at 60 m, or if her field of vision is less than 20° in diameter (a person with normal vision can see 180°).

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. 

Causes of vision impairment

Vision impairment can be caused by genetic conditions. It can also be caused by damage or injury to the eye, to the pathways connecting the eye to the brain or to the visual centre of the brain.  

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 babies that have particular problems during their birth 
  • conditions like paediatric glaucoma, cataracts and cancer – for example, retinoblastoma
  • infections by particular viruses during pregnancy – for example, rubella, cytomegalovirus, sexually transmitted infection, toxoplasmosis and so on.

Early signs and symptoms of vision impairment

Children who have vision loss might have normal-looking eyes. Often, it will be something about a child’s behaviour or the way he uses his eyes that makes you think there might be a problem with the way he sees.

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 she has trouble doing this.

Other signs that a baby might have a problem with his vision are if his:

  • eyes move quickly from side to side (nystagmus), jerk or wander randomly
  • eyes don’t follow your face or an object, or he doesn’t seem to make eye contact with family and friends
  • eyes don’t react to bright light being turned on in the room
  • pupils seem white or cloudy rather than black
  • eyes don’t line up but look towards his nose or turn outwards.

An older child might:

  • hold things up close to her face
  • rub her eyes a lot
  • turn or tilt her 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
  • say she has tired eyes
  • seem to have misaligned eyes or a squint 
  • seem clumsy – for example, she might knock things over or trip often.
If you think your child has vision problems, it’s very important to visit your doctor as soon as possible.

Diagnosis of vision impairment

Getting a diagnosis is the first step to the right intervention.

If you’re worried about your child’s vision, you might want to see a GP or paediatrician to get your child’s eyes checked. Your GP or paediatrician can send you on to a children’s eye specialist – a paediatric ophthalmologist. The ophthalmologist will be able to examine your child and do tests to work out what the problem is.

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

Early intervention services for children with vision impairment

Once your child has a diagnosis of vision impairment, you can get access to early intervention services and specialists.

Children with all kinds of vision loss can get a lot out of early intervention. In particular, children with vision impairment caused by brain damage or injury might have a combination of learning, hearing, physical and speech disabilities and developmental delay. When you work with early intervention services, together you can come up with strategies to help your child overcome these challenges.

The early intervention services can also do further assessment and help your child learn new skills. And they can help you learn how to do things to support your child’s development in your everyday play and communication together. Children learn the most from the people who care for them and with whom they spend most of their time.

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 and special education teachers.

Effects of blindness

Blindness can affect lots of areas of your child’s development, some of which you might not expect.

Your child might have extra challenges with:

  • communicating – for example, your child might not see someone waving and smiling at him or not be able to make eye contact
  • playing and socialising with others – for example, your child might be clumsy, not able to read non-verbal cues and gestures, get lost in a crowd or have trouble making friends
  • talking – for example, your baby might not point to objects, so that the people around him won’t name these objects, and he’ll 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 he can’t see the interesting objects you put out for him
  • learning to read and write
  • playing – for example, your child might be afraid to touch certain textures or explore areas he can’t see.
Engaging your child in exploring her environment using whatever vision she has – and linking the vision she has with all of her other senses – will help spark her curiosity about the world around her.

Services and support or children with vision impairment

It can be hard to know what to do when your child gets a diagnosis of vision impairment. Here are some ideas to get you started.

Learning more
Learning as much as possible from the specialists that you speak with will help. Don’t be afraid to ask lots of questions. Forming a relationship with these professionals, as well as the therapists and educators, means that they can keep working with you and your child as he grows and becomes more independent.

If you need more information about vision impairment, good places to start are:

The services system
Many services and supports can help your child achieve her potential. But finding your way through the disability services system can be tricky. Our Disability Services Overview can help.

Financial support
If you live in a National Disability Insurance Scheme (NDIS) trial area and your child has a confirmed diagnosis of vision impairment, your child can get support under the NDIS. The NDIS helps you get services and support in your community, and gives you funding for things like early intervention therapies or one-off items like a guide dog.

If you don’t live in one of the NDIS trial areas, your child can get funding under the Better Start for Children with Disability initiative. If your child is eligible for the NDIS, she’ll be moved over when it becomes available in your area. Read our NDIS and Better Start FAQs for more information.

Looking after yourself

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’re physically and mentally well, 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 a similar situation in our parents of children with vision impairment forum or by joining support groups organised by your disability service provider.
  • Last updated or reviewed 23-03-2016
  • Acknowledgements This article was developed in collaboration with Sue Silveira, Royal Institute for Deaf and Blind Children (RIDBC), Vision Australia and the Better Start initiative. It was funded by the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs.