The child does not say he cannot see: The signs you need to know before first grade
How to identify myopia, which signs should raise a red flag, when is it important to get an eye exam, and what can be done to reduce the impact of screens on children's vision? Dr. Hana Rena, an ophthalmology specialist at Meuhedet, explains: "One of the challenges in identifying vision problems in children is that they do not always complain. Therefore, parents should pay attention to changes in behavior."
Entering first grade and returning to school bring with them excitement and many changes: longer hours in front of books and notebooks, reading and writing, working in front of a computer or tablet, and doing homework. Among all the preparations for the school year, there is one thing that is easy to forget - to ensure that the child simply sees well.
Dr. Hana Rena, an ophthalmology specialist at the Meuhedet clinic in Netanya, explains that normal vision is a significant component of functioning at school. "A child who does not see the board well, has difficulty reading, or struggles to focus on text will not always know how to explain that the problem is with their vision," she says. "From their perspective, this is how the world looks - and they do not necessarily know that it is possible to see differently."
Entering first grade is not just an academic transition point, but also a significant period in terms of vision. Data from a government survey conducted in Taiwan, cited in a study published in 2025 in the journal Clinical & Experimental Ophthalmology, point to a jump in the prevalence of myopia around the start of school: from 9% among kindergarten children to 19.8% in first grade and to 38.7% in second grade. The researchers emphasize that these data illustrate the importance of early detection and monitoring of children at risk of developing myopia.
Signs to watch for
"One of the challenges in identifying vision problems in children is that they do not always complain," says Dr. Rena. "Therefore, parents should pay attention to changes in behavior." A child may need an eye exam if they:
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Get very close to a screen, book, or notebook.
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Have difficulty identifying things from a distance.
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Squint or narrow their eyes when looking at the board or television.
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Complain of headaches after reading or studying.
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Rub their eyes frequently or lose concentration on tasks requiring near vision.
Also, a child's complaint that they do not see the board well, repeated mistakes in copying from it, or a constant desire to sit close to it are signs that should be addressed, rather than assuming it is just a lack of concentration.
Myopia: Important to identify early
With myopia, the child usually sees close objects well but has difficulty seeing clearly at a distance. The phenomenon can develop and progress during childhood and adolescence. A systematic review and large-scale meta-analysis, published in 2025 in the British Journal of Ophthalmology, showed that the prevalence of myopia rose from about 24% in 1990 to about 36% in 2023. Researchers estimate that by 2050, nearly 40% of children and adolescents in the world will suffer from myopia.
Factors studied include genetic predisposition, time dedicated to near-work, and a lack of time spent outdoors. Dr. Rena notes: "Daily exposure to daylight and outdoor activity have been linked in studies to a reduced risk of developing myopia in children. Therefore, alongside limiting screen time, it is worth making time outdoors a regular part of the daily routine."
What about screens?
The goal is not to remove screens completely, but to instill correct usage habits. For children ages two to five, it is recommended to limit screen time to about an hour a day. Among school-age children, the emphasis is on setting fixed boundaries so that screen use does not come at the expense of sleep, physical activity, and studies.
"One of the simple habits that is worth adopting is regular breaks during prolonged near-work: occasionally shift the gaze from the screen or book and look into the distance," says Dr. Rena. "It is also worth ensuring a reasonable distance from the screen, good lighting, and avoiding as much as possible holding the phone to the eyes for a long time."
Towards first grade, the recommendation to parents is simple: pay attention to the children's visual habits. A timely eye exam is a simple action that can identify a problem at an early stage, allow for appropriate treatment, and save the child unnecessary effort and frustration.
