We parents hate to see our kids in pain. Whether it’s the skinned knee from unsteady toddler feet wobbling down a sidewalk, a broken ankle on the soccer field, or the innumerable other possibilities that are far more serious, it’s safe to say we often wish we could somehow spare them the pain altogether or at the very least, help them navigate away from it as swiftly and healthily as possible. This becomes even more complicated when the pain is elusive or somewhat mysterious, such as when a child complains of eye pain.
Dr. Kellye Knueppel of The Vision Therapy Center often works with families to help diagnose the cause of eye pain and is eager to help parents understand more about this potential barrier to their child’s wellbeing.
Could This Be the Reason Why Your Child’s Eyes Still Hurt?
“Why do my child’s eyes hurt?” I’ve heard versions of this question countless times over my 30 years as a developmental optometrist. Eye pain can take on many forms and has a number of possible sources. But many causes — poor tear production, an eye infection, to name two examples — are generally easier to detect than others.
If your child complains about their eyes hurting and you (and your doctors) can’t seem to figure out why, it could be the following reason.
An Undetected Functional Vision Problem
Functional vision is how your entire visual system — the eyes, the brain, the visual pathways — works together to help you interact with your environment. More specifically, it involves these skills:
- Eye teaming. In normal vision, this occurs when both your eyes align to focus on the same point in space and work together in a precise and coordinated way.
- Eye focusing. This encompasses your ability to see an object clearly and to shift focus between objects at different distances.
- Eye movement. This includes your eyes’ ability to maintain fixation on a moving object through space, to move fixation from one object to another, or to sustain fixation on a stationary object.
Unfortunately, if there is a problem with one or more of these skills, this can lead to a number of related learning problems.
It can also cause the eyes to hurt. Let’s take a closer look.
Pain Behind the Eyes
When a child complains about eye pain that feels like it’s at the back of their eyes or behind the eyes, it could be the result of an undetected functional vision problem.
Why does it occur? One reason could be that their eyes are working too hard to focus on a nearby object. Reading a book or looking at a computer screen, for example, requires the muscles in a person’s focusing system to contract in order to bring the object into focus.
But if this system doesn’t work efficiently, the extra effort required to bring the object into focus could result in pain or discomfort, which can be experienced in or behind the eyes, and even in the forehead area. (Check out Why Did This High School Student’s Eyes Hurt So Much? for a real-life example.)
Note that a physically tired child may also have trouble focusing. In this case, it’s possible for the child to experience eye discomfort even if they have normal functional vision.
Sensitivity and Discomfort Due to Light
Sensitivity to light can range from mild discomfort to a stabbing pain. We’re all sensitive to light to some degree. But if your child appears to have light sensitivity that affects everyday life, it could be something more serious such as photophobia, an extreme sensitivity to or intolerance of light.
Be on the lookout if your child:
- Avoids going outside on sunny days.
- Can’t work in a room with fluorescent lighting.
- Shows sensitivity to car headlights at night.
- Has more difficulty looking at your computer screen than looking at printed information.
Possible causes of photophobia include:
- Pathologies (such as infection, inflammation or elevated eye pressure)
- Brain injuries
- Migraine headaches
- Refractive conditions (e.g., nearsightedness, farsightedness, and/or astigmatism)
- Corneal issues
- Dry eye
- Medication side effects
But photophobia may also be caused by a functional vision problem, especially if it’s been an ongoing condition.
Photophobia and Functional Vision Problems
Photophobia may be experienced by a child who has problems with the functional vision skills of eye teaming and/or eye focusing. (See above for definitions of these skills.)
We’re not entirely sure why this occurs, though one theory is that the brain is having trouble “organizing” the light. Dr. John Streff, a pioneer in vision theory, has said that light glare is “light you cannot organize or ignore.”
(One specific example of a functional vision problem that produces photophobia is exotropia, which is a form of strabismus in which one or both eyes turn out.)
Special Note on Light Sources
If your child shows sensitivity to fluorescent light specifically, it could simply mean they need different lighting. I recommend using full spectrum lighting in both schools and the home.
Also, your child shouldn’t be able to see a light source’s reflection on the computer screen.
And speaking of the computer, it should not be the sole source of light in a room. It’s important to have ambient lighting to facilitate awareness of visual space around and beyond the computer. Just make sure that the ambient light sources are not directly visible to the eye. The use of lamp shades, for example, helps diffuse the light.
For more information, check out Photophobia: A Surprising Reason Why You’re Experiencing Light Sensitivity. Also, if you’re concerned about the amount of time your child stares at a screen, take a look at Screen Time Study Reveals Effects on Children’s Development.
A Vision Quiz Can Be the First Step Toward Identifying the Problem
Eye pain of any type shouldn’t be ignored. If your child’s eyes are hurting, take steps immediately to see an optometrist.
If you suspect your child may have a functional vision problem based on the information above, I strongly recommend you take The Vision Therapy Center’s free online Vision Quiz.
If your child does have a functional vision problem, there’s good news: Optometric vision therapy has proven to be highly effective at solving a wide range of functional vision problems.
About the author: Dr. Kellye Knueppel is a developmental optometrist specializing in vision related learning problems, sports vision, and rehabilitative optometry. She is board certified in vision development as a Fellow of the College of Optometrists in Vision Development. Since opening The Vision Therapy Center in 1995, she has dedicated herself to helping people overcome their visual problems.