Pediatric Eye Centre, BNH Hospital
Good vision supports healthy development.
Don’t let vision problems hold your child back.
A child’s eye health not only affects their vision today but also their development, which relies heavily on visual stimulation. If vision problems are not addressed during the critical stages of visual development, the consequences can last a lifetime.
BNH Hospital, renowned for its internationally recognised expertise in maternal and child healthcare for over a century, understands the importance of children’s eye health. We have assembled a team of specialist paediatric ophthalmologists who are trained to communicate with, diagnose, treat, and care for children in ways that differ from adult care. Working closely with paediatricians and other specialists, they provide comprehensive, holistic care to support age-appropriate development and overall well-being, both now and in the future.
Why trust BNH Hospital with your child's eye health?
- Specialist Paediatric Ophthalmologists Children’s eyes require a different approach from adults’. As children have a much stronger focusing ability, standard vision tests may not provide accurate results. This is why children should be assessed by specialist paediatric ophthalmologists who are experienced in communicating with young patients and in diagnosing, treating, and managing childhood eye conditions.
- Continuous Eye Care Throughout Every Stage of Childhood We provide personalised eye care throughout every stage of your child’s development to help prevent long-term vision problems. By monitoring your child’s visual development over time, our specialists can identify abnormalities early and reduce the risk of serious eye conditions in the future.
- Comprehensive, Holistic Assessment Our paediatric ophthalmologists work closely with paediatricians and other specialists to provide integrated care. This multidisciplinary approach helps identify and manage conditions associated with vision, including developmental disorders, diabetes, and childhood hypertension.
- Personalised Vision Care for Every Child At the heart of the BNH Eye Centre is our multidisciplinary team. Beyond specialist ophthalmologists, our team includes experts in corneal diseases, retinal disorders, glaucoma, cataracts, orbital and oculoplastic surgery, as well as paediatric ophthalmology. We also work alongside optometrists and specialist nurses to develop an individualised care plan for every child. Because every child’s eyes are unique, we tailor treatment and lifestyle recommendations to suit both the child’s needs and their family’s lifestyle.
- Comprehensive Optical Services Accurate spectacle prescriptions play a vital role in treating refractive errors. Glasses must be precisely manufactured according to the prescription provided by the ophthalmologist to ensure the best visual outcomes. At BNH Hospital, we provide a seamless service covering every step of the process, helping minimise errors and ensuring the highest standard of care.
- Family-Centred Care Beyond the Hospital Looking after a child’s vision extends beyond the clinic. Successful treatment depends on the ongoing support of parents and the cooperation of the child. Our specialists therefore create personalised care plans that fit each child’s personality and family circumstances, enabling parents to continue treatment confidently at home. For example, we offer practical solutions for children who become distressed every time they need eye drops.
Focused on Annual Follow-up Care
Close monitoring of children’s eye health is essential because their eyes undergo rapid physical and functional changes. What seems normal today may develop abnormalities in 6-12 months, such as strabismus, limited eye movement, or refractive errors.
These are visual abnormalities that parents must take very seriously, as children’s communication abilities are limited, and by the time parents notice a problem, it may be too severe to treat. Furthermore, loss of vision can impact a child’s development.
Therefore, it is crucial to have regular eye check-ups with a specialist at least once a year, especially for preschool and school-aged children. Ophthalmologists can diagnose visual abnormalities that parents may not notice, such as eye pain, color blindness, and blurred vision, which can affect a child’s emotional and learning abilities.
Regular eye check-ups allow for early detection and treatment of problems, reducing the risk of serious eye diseases and ensuring children don’t miss crucial periods when clear vision is essential for their visual, emotional, and learning development
ตรวจสอบสารก่อภูมิแพ้ที่หลากหลายและเจาะลึกถึงระดับโมเลกุล
Little Eyes Care Package
Ensure your child’s vision with confidence through the screening program led by pediatric ophthalmology specialists.
Annual eye exams are recommended to detect issues early and help prevent long-term vision problems.
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Myopia (Short-sightedness)
The World Health Organization (WHO) estimates that by 2050, more than half of the world’s population will be affected by myopia, with around 10% developing high myopia. The trend is particularly evident across Asia, including Thailand, where children are developing myopia at increasingly younger ages due to prolonged near work and reduced time spent outdoors.
Myopia is more than simply blurred distance vision. It is caused by excessive elongation of the eyeball, a structural change that increases the lifetime risk of serious eye diseases, including retinal detachment, myopic macular degeneration, glaucoma, and early-onset cataracts.
The aim of managing childhood myopia is not only to provide clear vision today but also to slow its progression and reduce the risk of future eye disease. Parents should pay close attention to two key factors: how early myopia develops and how quickly it progresses. Children who become short-sighted at a younger age are more likely to develop high myopia later in life, while delayed diagnosis may mean missing the opportunity to begin effective myopia control at the most beneficial stage.
Risk Factors for Childhood Myopia
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- Family history
Genetics play an important role in the development of myopia. If one parent is short-sighted, a child has an estimated 20% risk of developing myopia. The risk increases to approximately 40% if both parents have high myopia.
- Lifestyle factors Children today spend increasing amounts of time engaged in near work, including using digital devices, online learning, reading, and other close-up activities. Prolonged near work is associated with an increased risk of developing and progressing myopia.
- Limited outdoor time Research consistently shows that children who spend at least two hours outdoors each day are less likely to develop myopia. Exposure to natural daylight is thought to stimulate dopamine release in the retina, helping to slow excessive eye growth and reduce the onset and progression of myopia.
Warning Signs Parents Should Look Out For
Children often do not realise that their vision is blurred, and even if they do, they may not be able to describe what they are experiencing. As a result, parents may only become aware of a problem when they notice changes in their child’s behaviour. Common warning signs include:
- Squinting to see distant objects.
- Sitting unusually close to the television or digital screens.
- Complaining of eye strain or headaches after school or prolonged near work.
- Difficulty concentrating or a decline in school performance.
- Frequent blinking or rubbing the eyes.
- Reluctance to take part in outdoor activities.
Myopia Control
Myopia control aims to slow the progression of short-sightedness and excessive eye growth during childhood. Slowing myopia progression can significantly reduce the likelihood of developing high myopia, which is associated with an increased risk of serious eye diseases later in life.
At BNH Hospital, every myopia management plan is tailored to the individual child. Our paediatric ophthalmologists consider a range of factors, including the age at which myopia first developed, the rate of progression, the current degree of myopia, binocular vision and eye coordination, and the child’s and family’s ability to follow the treatment plan.
Following a comprehensive assessment, a personalised treatment plan is developed. Children are reviewed every 3–6 months to monitor changes in refractive error and eye growth, allowing treatment to be adjusted according to their response.
Treatment options may include:
- Low-dose atropine eye drops, prescribed and adjusted according to the child’s response.
- Optical treatments, including myopia control spectacle lenses and orthokeratology (Ortho-K) for suitable candidates.
- Lifestyle modifications, such as encouraging at least two hours of outdoor activity each day, reducing unnecessary screen time, and taking regular breaks during prolonged near work.
Five Things Every Parent Should Know About Childhood Myopia
- Myopia is a long-term condition that requires ongoing monitoring. Regular follow-up is essential to preserve healthy vision throughout childhood and into adult life.
- The earlier myopia develops, the earlier treatment should begin. Children should wear glasses when prescribed, even at a young age. Clear vision is essential during the years when the visual system is still developing. Left untreated, blurred vision may lead to amblyopia (lazy eye) and affect learning and development.
- Children should be assessed by a specialist paediatric ophthalmologist. Children’s eyes are not simply smaller versions of adult eyes. Accurate examination requires specialist knowledge, child-friendly examination techniques, and an understanding of visual development.
- Successful myopia control requires regular review. Treatment plans should be monitored and adjusted over time to achieve the best possible outcome.
- Outdoor time is one of the most effective ways to help protect children’s vision. Encourage your child to spend at least two hours outdoors each day, alongside healthy screen habits and regular breaks during near work, to help reduce the risk of myopia progression.
Strabismus (Squint)
Strabismus, commonly known as a squint, is a condition in which the eyes are not properly aligned and do not work together as a team. One eye may turn inwards, outwards, upwards, or downwards, causing the brain to rely more heavily on the image from one eye while suppressing the other.
Normal visual development depends on both eyes seeing clearly and working together in proper alignment. If either eye has reduced vision or the eyes are not aligned, visual development may be affected, increasing the risk of amblyopia (lazy eye) and, in severe cases, permanent visual impairment.
Common Causes
- Poor coordination between the two eyes.
- A family history of strabismus.
- Disorders affecting the eye muscles or the nerves that control them.
- Uncorrected refractive errors, particularly long-sightedness (hyperopia).
- Excessive focusing effort associated with long-sightedness.
- Eye conditions that reduce vision in one eye.
Warning Signs Parents Should Look Out For
- One or both eyes appear to turn inwards, outwards, upwards, or downwards.
- Frequent head tilting or turning when looking at objects.
- Closing or covering one eye, particularly in bright sunlight.
- Difficulty judging distances or reaching accurately for objects.
- Children aged five months or older who appear to have a squint should be assessed by a specialist paediatric ophthalmologist as soon as possible.
Potential Consequences of Untreated Strabismus
- Effects on Vision Untreated strabismus may lead to amblyopia (lazy eye), reduced depth perception (3D vision), impaired vision, and, in some cases, permanent visual impairment.
- Emotional and Social Well-being Children with a visible squint may become self-conscious or experience teasing, which can affect their confidence, emotional well-being, learning, and social development.
Treatment for Strabismus
Childhood strabismus should be treated as early as possible, particularly during the critical years of visual development. Treatment is generally most effective during the first four to seven years of life. Delayed treatment may reduce the likelihood of achieving the best possible visual outcome.
Treatment depends on the underlying cause and may include:
- Treatment for amblyopia (lazy eye) by patching the stronger eye for 2–6 hours a day to encourage the weaker eye to develop normal vision.
- Corrective glasses for children whose strabismus is associated with refractive errors, particularly long-sightedness (hyperopia).
- Prism lenses to improve eye alignment in selected cases.
- Eye exercises, where clinically appropriate.
- Botulinum toxin (Botox®) injections in selected cases.
- Eye muscle surgery to adjust the position of the eye muscles and improve eye alignment. This is an extraocular procedure that does not involve operating inside the eye. When clinically indicated, surgery can usually be performed from around two years of age. Mild redness is common after the procedure, with most children recovering within about one week. Regular follow-up appointments are essential to monitor visual development and eye alignment.
Four Things Every Parent Should Know About Strabismus
- Strabismus does not usually resolve on its own. Children with a squint should not simply be observed in the hope that the condition will improve with age.
- Early treatment helps protect your child’s vision. Prompt treatment can reduce the risk of amblyopia (lazy eye) and permanent visual impairment.
- Treatment is about more than appearance. The primary goal is to promote healthy visual development, improve binocular vision, and protect long-term eyesight.
- Early assessment by a specialist is essential. Any child with suspected strabismus should be examined promptly by a specialist paediatric ophthalmologist.
Amblyopia (Lazy Eye)
Amblyopia, commonly known as lazy eye, is a childhood vision disorder that develops when one eye does not receive a clear or balanced visual image during the critical years of visual development. Over time, the brain begins to favour the stronger eye and suppresses the image from the weaker eye, preventing normal vision from developing.
Amblyopia usually occurs even though the eye itself appears structurally normal. However, if left untreated during childhood, it can lead to permanent visual impairment.
Common Causes
- Refractive amblyopia A significant difference in refractive error between the two eyes (anisometropia), or a high refractive error in both eyes that is left uncorrected.
- Strabismic amblyopia The brain suppresses the image from one eye to avoid double vision caused by a squint (strabismus).
- Deprivation amblyopia Reduced vision caused by an obstruction to the visual pathway, such as a congenital cataract, corneal opacity, or severe drooping of the eyelid (ptosis).
- Reverse amblyopia A rare complication that can occur if patching therapy is not carefully monitored, causing vision in the stronger eye to become temporarily reduced.
Warning Signs Parents Should Look Out For
Most children with amblyopia do not realise that one eye has poorer vision, so parents should watch for signs such as:
- Squinting or tilting the head when looking at objects.
- Closing or covering one eye while focusing.
- A visible squint (strabismus).
- Difficulty judging distances or reaching accurately for objects.
- Poor concentration or a decline in school performance.
- Reduced interest in reading or other visually demanding activities.
Diagnosis and Treatment
Diagnosing amblyopia involves confirming reduced vision that cannot be explained by refractive error alone, while identifying the underlying cause, such as strabismus, refractive error, or ptosis. If no obvious cause is found, a comprehensive eye examination is performed to look for conditions affecting the retina, optic nerve, or other structures of the eye.
When detected early—particularly before the age of seven or eight—amblyopia can often be successfully treated. Treatment focuses on correcting the underlying cause and encouraging the weaker eye to develop normal vision.
Treatment may include:
- Treating the underlying condition, such as cataracts, ptosis, or strabismus.
- Prescribing corrective glasses where appropriate.
- Patching the stronger eye to stimulate vision in the weaker eye.
- Other treatments, such as atropine eye drops, in selected cases.
Three Things Every Parent Should Know About Amblyopia
- Amblyopia is one of the leading causes of preventable visual impairment in children.
- It often develops without obvious symptoms. Many children are unaware that one eye sees less clearly than the other, making regular eye examinations essential.
- Early detection offers the best chance of successful treatment. Comprehensive eye examinations before starting school can help detect amblyopia early and prevent permanent visual impairment.
Our Team of Specialist Paediatric Ophthalmologists
Rattiya Pornchaisuree, M.D.
Warakorn Thiamthat, M.D.
Withawat Sapthanakorn, M.D.
Puncharut Preechaharn, M.D.
Benjawan Wutthiworawong, M.D.
Pruke Vichaiya, M.D.
ตรวจสอบสารก่อภูมิแพ้ที่หลากหลายและเจาะลึกถึงระดับโมเลกุล
Little Eyes Care Package
Ensure your child’s vision with confidence through the screening program led by pediatric ophthalmology specialists.
Annual eye exams are recommended to detect issues early and help prevent long-term vision problems.
