Your Child May Not Complain About Eyesight — But a Problem Could Still Be Hiding: Doctors Urge Eye Checks From Age Three

Four-year-old Terezka from Prague never once complained about her eyesight — she played happily, ran around outside, and pored over picture books like any other child. But her mother noticed something odd: the girl kept holding objects unusually close to her face and tilted her head strangely whenever she looked at something. A simple home test — covering one eye, then the other — revealed that something was clearly wrong with how she saw. A full examination later confirmed a serious diagnosis: 5.5 dioptres in each eye, plus astigmatism.

"Terezka had no idea she was seeing poorly, because she'd never known anything different. She simply had no reference point — no memory of sharp vision to compare it to. Whatever she saw had always seemed normal to her," her mother explained. Today the girl wears glasses almost all the time and treats them as simply part of who she is.

First Check-Up at Age Three

According to doctors, many children start kindergarten or school with an undiagnosed vision problem. Specialists strongly recommend a first preventive eye exam at around age three — even if the child shows no obvious symptoms. "Young children don't realise their vision is poor. If blurry sight has been with them since early childhood, they simply assume it's normal. What tends to alert parents is squinting or a visible eye turn," explains Andrea Janeková, head doctor at Prague's Oční centrum Praha.

Squinting, or strabismus, is fairly common in children, and the causes vary widely — from severe farsightedness and astigmatism to congenital issues with the eye muscles or nerves, as well as genetics. According to Eva Jergutová, an ophthalmologist at Prague's Neovize clinic, childhood strabismus is frequently linked to an underlying vision problem that simply needs correcting with glasses.

If caught early — ideally by age three, and no later than eight — strabismus can usually be fully corrected. Left untreated, however, it can develop into amblyopia, or "lazy eye": the brain suppresses the blurrier image from the misaligned eye to avoid double vision, and that eye effectively gets "switched off."

Warning Signs in the Classroom

A separate concern is myopia, or nearsightedness — blurred distance vision. Specialists say cases among Czech children have risen by 30% over the past decade, with roughly 200,000 children nationwide now affected. Banning screens outright isn't the answer; what matters is making sure close-up screen time is regularly interrupted by looking into the distance, and that children spend enough time outdoors every day.

A child may not even realise their eyesight is worse than their peers'. Among younger schoolchildren especially, the problem often shows up indirectly — through poor concentration, fatigue, reluctance to read, or headaches. Parents frequently notice these signs before the child does, notes Petra Pruchová, an optometrist at Lentiamo.

Specialists point to several warning signs: declining concentration and quick tiredness, avoiding reading or homework, squinting, holding objects too close or tilting the head, complaints of headaches or burning eyes, and a noticeable drop in performance during sports or active play.

Doctors recommend limiting screen time to no more than an hour a day for preschoolers and two hours for school-age children, ensuring at least two hours of daylight exposure outdoors every day, and having children's eyes checked before starting school, then once a year and whenever any concerns arise.

Around Prague, based on reporting by denik.cz