Paediatric & General Eye Conditions

What are paediatric & general eye conditions?

Eye problems can affect people at any age, but some conditions are especially important to identify early in childhood because vision is still developing. Other symptoms — such as a red eye, light sensitivity, eye pain or a sudden change in vision — can have many possible causes and may occasionally signal a problem that needs urgent treatment.

At personalEYES, our ophthalmologists assess a wide range of eye conditions in children and adults. A thorough eye examination can help determine what is causing symptoms, whether treatment is needed and how best to protect vision over the long term.

Important: Sudden loss of vision, a serious eye injury, severe eye pain, or a red painful eye with reduced vision or marked light sensitivity should not wait for a routine appointment. Seek urgent medical assessment.

Amblyopia (Lazy Eye)

Amblyopia, commonly called lazy eye, is reduced vision in one eye — and less commonly both eyes — because the visual system did not develop normally during early childhood. The eye itself may look normal, but the brain learns to rely more heavily on the stronger eye. Because visual development happens mainly in childhood, finding and treating amblyopia early gives a child the best chance of developing useful vision in the weaker eye.

For parents and carers: Amblyopia is a problem of visual development, not simply an eye that “looks lazy”. A child can have amblyopia even when both eyes appear straight.

Common signs and symptoms

• One eye that appears to wander inwards or outwards
• Squinting, closing or covering one eye
• Tilting or turning the head to see
• Difficulty judging depth or distances
• Poor vision in one eye found during an eye test
• Sometimes no obvious symptoms at all

What can cause it?

Amblyopia can develop when the two eyes provide the brain with unequal visual information. Causes include strabismus, a significant difference in prescription between the eyes, high refractive error in both eyes, or something that blocks clear vision in early life such as a cataract or droopy eyelid.

How is it diagnosed?

An eye examination checks vision in each eye separately, eye alignment, focusing and the health of the eye. In young children, specialised age-appropriate tests can be used even before they can read an eye chart. Dilating drops may be used to accurately measure the glasses prescription and examine the inside of the eye.

How is it treated?

Treatment depends on the cause. Glasses are often the first step. If one eye remains weaker, treatment may include patching the stronger eye or using drops to temporarily blur it so the brain uses the weaker eye more. If another condition is blocking vision, such as cataract or significant ptosis, surgery may be required. Follow-up is important because treatment is adjusted as vision improves and amblyopia can sometimes recur.

When to seek urgent medical attention: Arrange an eye assessment if a child consistently closes one eye, has an eye that turns, develops an unusual head posture or seems to have difficulty seeing. Early treatment is generally more effective than waiting until later childhood.

Strabismus (Squint)

Strabismus, also known as a squint or eye turn, occurs when the eyes do not point in the same direction. One eye may turn inwards, outwards, upwards or downwards, either all the time or intermittently. Strabismus is common in children but can also develop in adults.

For parents and carers: Some newborns appear cross-eyed intermittently during the first weeks of life, but an eye that continues to turn or repeatedly drifts should be checked.

Common signs and symptoms

• One eye turning in, out, up or down
• Eyes that do not appear to move together
• Closing one eye in bright light
• Tilting or turning the head
• Reduced depth perception
• Double vision, particularly when strabismus begins in an older child or adult

What can cause it?

Strabismus can be associated with refractive error, differences in vision between the eyes, problems with eye-muscle control, nerve conditions or other eye disease. In children it can lead to amblyopia if the brain begins to ignore the image from the misaligned eye.

How is it diagnosed?

Assessment usually includes measuring vision in each eye, checking the glasses prescription, examining how the eyes move and measuring the direction and size of the eye turn. The ophthalmologist may also examine the eye itself to make sure there is no underlying eye disease contributing to the strabismus.

How is it treated?

Treatment is tailored to the cause and may include glasses, treatment of associated amblyopia, prisms in selected patients, and eye-muscle surgery. Surgery changes the position or tension of selected eye muscles to improve alignment. Patching is used to treat associated amblyopia; it does not directly straighten the eye.

When to seek urgent medical attention: A new or sudden eye turn, particularly with double vision, headache, drooping eyelid, weakness, imbalance or other neurological symptoms, should be assessed promptly. In babies and young children, a persistent eye turn should also be assessed rather than assumed to be something they will “grow out of”.

Allergic Eye Disease

Allergic eye disease occurs when the surface of the eye reacts to allergens such as pollen, dust mites, mould or animal dander. The most common form is allergic conjunctivitis. Symptoms may be seasonal, especially during spring, or occur throughout the year. Some children and young adults can develop more persistent forms of allergy-related inflammation that need specialist treatment.

Common signs and symptoms

• Itchy eyes — often the most prominent symptom
• Redness of both eyes
• Watery or stringy discharge
• Puffy eyelids
• Burning or gritty sensation
• Symptoms occurring with hay fever, sneezing or an itchy nose
• Discomfort with contact lenses

What can cause it?

Allergic symptoms are caused by an immune reaction to an allergen. Seasonal pollen, house-dust mites, pets and mould are common triggers. People with eczema, asthma or hay fever may be more prone to allergic eye symptoms.

How is it diagnosed?

Your eye specialist will ask about triggers and examine the eyelids and eye surface. More severe or persistent cases may need careful examination of the cornea and the inside of the eyelids because chronic allergic inflammation can occasionally affect the cornea.

How is it treated?

Management can include avoiding known triggers where possible, cool compresses, preservative-free lubricating drops and anti-allergy eye drops such as antihistamine or mast-cell stabilising medicines. More severe inflammatory disease may require prescription treatment and ophthalmology follow-up. Steroid eye drops should only be used under eye-care supervision because inappropriate or prolonged use can cause complications.

When to seek urgent medical attention: Seek prompt assessment if an “allergy” becomes painful, causes reduced vision, marked light sensitivity, significant swelling, or affects mainly one eye. These features can indicate another eye condition rather than simple allergy.

Red Eye

A red eye is a symptom rather than a diagnosis. It happens when blood vessels on or around the surface of the eye become more visible. Many causes are minor, including irritation, allergy or conjunctivitis, but some causes can threaten vision if treatment is delayed.

Common signs and symptoms

• Redness affecting part or all of the white of the eye
• Watering or discharge
• Itching, burning or grittiness
• Swollen eyelids
• Light sensitivity
• Blurred or reduced vision
• Eye pain or headache

What can cause it?

Possible causes include allergic or infectious conjunctivitis, dry eye, blepharitis, a foreign body, corneal infection, uveitis, scleritis, injury and, less commonly, acute glaucoma. The pattern of symptoms — especially pain, discharge, vision change and light sensitivity — helps narrow down the cause.

How is it diagnosed?

An eye examination may include vision testing, slit-lamp examination, eye-pressure measurement and staining of the cornea. The treatment depends entirely on the underlying diagnosis, which is why persistent or painful red eyes should not be treated blindly with leftover drops.

How is it treated?

Treatment may range from lubrication or allergy management to antibiotics, antivirals, anti-inflammatory medication or urgent specialist procedures. Contact lens wearers with a painful red eye need prompt assessment because corneal infections can progress quickly.

When to seek urgent medical attention: Seek urgent eye care for a red eye with moderate to severe pain, reduced vision, marked light sensitivity, a very cloudy-looking cornea, significant trauma, severe headache or nausea, or if you wear contact lenses and the eye is painful.

Light Sensitivity (Photophobia)

Light sensitivity, medically known as photophobia, means that normal levels of light feel uncomfortable or painful. It can affect one or both eyes and may occur with headache, redness, watering or blurred vision. Photophobia is a symptom with many possible causes rather than a condition on its own.

Common signs and symptoms

• Needing to squint or close the eyes in ordinary light
• Eye discomfort or pain in bright environments
• Watering when exposed to light
• Headache
• Redness or blurred vision
• Difficulty using screens or being outdoors

What can cause it?

Light sensitivity can occur with migraine, dry eye, corneal irritation or abrasion, infection, uveitis and other inflammatory eye conditions. It can also occur after eye surgery or while the pupil is dilated. Because some serious corneal and inflammatory conditions cause photophobia, new or significant symptoms should not be ignored.

How is it diagnosed?

The cause is identified by reviewing when the symptom began, whether it affects one or both eyes, and whether pain, redness or vision changes are present. Examination may include testing vision, the cornea, pupils, eye pressure and the inside of the eye.

How is it treated?

Treatment focuses on the cause. Temporary measures such as sunglasses and reducing glare can improve comfort, but persistent photophobia should not simply be masked without identifying why it is occurring.

When to seek urgent medical attention: Seek prompt or urgent assessment if light sensitivity is new and significant, especially when combined with eye pain, redness, reduced vision, headache, recent injury or contact lens wear.

Eye Pain

Eye pain can be felt on the surface of the eye, around the eye or deeper behind it. Mild irritation may come from dryness or a foreign body, but severe or persistent pain can be a sign of corneal disease, inflammation, infection, injury, raised eye pressure or a condition involving the optic nerve.

Common signs and symptoms

• Burning, stinging or gritty discomfort
• Sharp or aching pain
• Pain with eye movement
• Pain associated with redness
• Headache or nausea
• Light sensitivity
• Blurred, reduced or altered vision

What can cause it?

Common causes range from dry eye and corneal scratches to infection, uveitis, scleritis, glaucoma, sinus-related pain and migraine. Pain behind the eye with vision or colour changes can also occur with optic nerve inflammation. The severity of pain alone does not always show how serious the condition is.

How is it diagnosed?

A detailed eye examination helps determine whether the pain originates from the eye surface, inside the eye, around the orbit or from another cause. Depending on the symptoms, further tests or imaging may occasionally be needed.

How is it treated?

Treatment varies widely and may include lubricants, removal of a foreign body, antimicrobial treatment, anti-inflammatory medication or treatment to lower eye pressure. Painkillers may improve comfort, but ongoing or severe pain needs a diagnosis rather than symptom treatment alone.

When to seek urgent medical attention: Seek urgent medical attention for severe eye pain, pain with reduced vision, a very red eye, marked light sensitivity, nausea or severe headache, pain after eye surgery or injury, or pain in a contact lens wearer — especially if vision is affected.

Sudden Vision Loss

Sudden vision loss is a medical emergency. Vision may disappear completely or become markedly blurred over seconds, minutes or hours. It can affect one eye or both eyes and may involve the centre of vision, the side vision, or appear as a dark curtain or missing area.

Common signs and symptoms

• Sudden loss or major blurring of vision
• A dark curtain, shadow or missing area of vision
• New flashes and a sudden increase in floaters
• Sudden distortion or central vision change
• Loss of part of the visual field
• Vision change with weakness, facial droop, speech difficulty or loss of balance

What can cause it?

Potential causes include retinal detachment, blockage of retinal blood vessels, bleeding inside the eye, acute glaucoma, optic nerve problems, severe corneal disease and neurological conditions such as stroke. Some causes are painless, so absence of pain does not make sudden vision loss safe to monitor at home.

How is it diagnosed?

Urgent assessment usually includes checking visual acuity, pupils, eye pressure, the retina and optic nerve. Imaging or medical investigations may be required depending on the suspected cause.

How is it treated?

Treatment depends on the diagnosis and is often time-sensitive. The priority is to obtain urgent medical assessment rather than trying home treatment or waiting to see whether vision returns.

When to seek urgent medical attention: Any sudden loss of vision should be investigated immediately. Go to the nearest emergency department or seek urgent ophthalmic care. If vision loss occurs with facial droop, arm or leg weakness, trouble speaking, severe dizziness or loss of balance, call Triple Zero (000) because these can be signs of stroke.

Eye Trauma

Eye trauma includes anything from a superficial scratch to a chemical burn, blunt injury, foreign body or penetrating injury. Even an injury that looks minor from the outside can sometimes damage deeper structures of the eye, so changes in vision or significant pain after trauma should be assessed.

Common signs and symptoms

• Eye pain, watering or a gritty sensation
• Redness or swelling
• Blurred or double vision
• Sensitivity to light
• Bleeding in or around the eye
• Difficulty opening or moving the eye
• An irregular pupil or visible cut
• A foreign object in or near the eye

What can cause it?

Eye injuries can occur from fingernails, branches, dust or metal fragments, sport, falls, projectiles, tools, chemicals and workplace accidents. Children may not always be able to clearly describe what happened or how well they can see after an injury.

How is it diagnosed?

The eye is examined carefully to check vision, the cornea, pupil, eye movements and internal structures. Dye may be used to identify a corneal scratch. If a penetrating injury, fracture or deep foreign body is suspected, imaging and urgent specialist assessment may be required.

How is it treated?

Treatment depends on the injury. Minor surface injuries may need lubrication or prescribed medication, while deeper injuries may require removal of a foreign body, antibiotics, surgery or other urgent treatment. For chemical exposure, immediate irrigation is the priority — start rinsing the eye with plenty of clean running water or saline straight away and seek urgent medical care. Do not delay irrigation while arranging transport.

When to seek urgent medical attention: Seek emergency care for chemical exposure, a penetrating or high-speed injury, an object embedded in the eye, sudden or reduced vision, severe pain, an irregular pupil, blood inside the eye or significant swelling. Do not try to remove an object that appears embedded in the eye and do not apply pressure to a suspected penetrating injury.

Quick guide: when should I be concerned?

• Child has an eye turn or one eye sees less well — possible strabismus or amblyopia; arrange an eye assessment, as earlier treatment is generally more effective.
• Both eyes itchy and watery, especially around pollen or pets — allergic eye disease is possible; avoid triggers where practical and seek advice if symptoms persist or are significant.
• Red eye with mild itch or discharge but normal vision — may be conjunctivitis, allergy or irritation; assessment is appropriate if it persists, worsens or the cause is unclear.
• Red eye with pain, photophobia or reduced vision — could be corneal or internal eye inflammation; seek prompt or urgent eye assessment.
• Sudden major change or loss of vision — potentially a sight-threatening eye or neurological problem; seek emergency assessment immediately.
• Chemical, penetrating or high-speed eye injury — potentially sight-threatening trauma; emergency care, and irrigate chemical injuries immediately.