Facts

  • Visual abnormalities are common in babies and young children - most are not caused by a brain tumour.
  • When looking for signs of a brain tumour, there are two main types of visual abnormality to be aware of: abnormal eye movements, and changes to vision, such as blurred or double vision.
  • Damage to one of the nerves controlling eye movements by a brain tumour (the 4th cranial or trochlear nerve) may cause children to hold their head in an abnormal position (head tilt / wry neck)
  • Neurofibromatosis (http://www.nfauk.org/) is a specific medical condition associated with tumours in the optic nerves and may cause loss of vision or a bulging eye (proptosis).

Further information about eye problems and eye health can be found at NHS Direct at: https://www.nhsdirect.nhs.uk/CheckSymptoms/SATs/EyeProblems.aspx

Preschool under 5

The most common visual abnormality occurring in this age group is a squint, in which the two eyes do not look in the same direction.

Squints are very rarely caused by a brain tumour, but do require assessment by an eye specialist when first noted - select for more information on squints.

Abnormal appearance or movements of the eye are an important symptom to look out for - for example, if one eye is bulging, or if the eyes appear wobbly, quivering or flicking.

In this age group many children are unable to describe problems seeing.

Their behaviour may indicate that they are having problems seeing, for example:

  • Reduced awareness of people or toys in front of them
  • Reduced ability to focus on people and/or to follow moving objects with their eyes
  • Increased stumbling, or bumping into things as they move around.
  • Choosing to sit closer to the television to watch it.
  • Nursery or school staff may notice changes during class activities that involve visual signals or information
  • Any child with vision abnormalities should be seen by a doctor.

    If the visual abnormality is accompanied by one or more other symptoms from the HeadSmart symptoms list, an urgent appointment should be made.

    Young children are often unable to describe visual abnormalities and can adapt well to visual loss - identifying visual problems in this age group requires careful assessment.

    Select for more general information for parents and carers.

Children 5-11

Abnormal appearance or movements of the eye are an important symptom to look out for - for example a new squint (eyes looking in different directions), one eye is bulging, wobbly, quivering or flicking eyes.

Other visual symptoms that may be caused by a brain tumour include blurred and/or double vision, and changes to vision and eyesight .

If a child has blurred or double vision, they may not describe this, but may behave differently to help them to see, for example, they may narrow their eyes when focusing, cover one eye with their hand, turn their head in unusual ways, or look sideways instead of forwards.

In this age group, a child may also not recognise or be able to describe a deterioration in their eyesight. However, again there may behaviour changes, such as them becoming more clingy in unfamiliar surroundings, sitting closer to the television to watch it, and being less aware of people or objects to the sides, above or below.

Their reading ability may also deteriorate and they may have difficulty in lessons where the teacher displays information at the front of the classroom.

Any child with vision abnormalities should be seen by a doctor or optician.

If they have visual problems that are accompanied by one or more other symptoms from the HeadSmart symptoms list, an urgent appointment should be made.

Select for more general information for parents and carers.

Young adult 12-18

Abnormal appearance or movements of the eye are important symptoms to look out for - for example a new squint (eyes looking in different directions), one eye is bulging, wobbly, quivering or flicking eyes.

Other visual symptoms that may be caused by a brain tumour include blurred and/or double vision, and a worsening in vision and eyesight - be particularly aware where these have occurred suddenly.

Double vision is where your eye doesn't work quite as it should and you see two images of a single object that you are looking at rather than one. With blurred vision, a single image will appear but will be unclear.

Indications of sight problems include:

  • Difficulty seeing when the teacher displays information at the front of the room at school or college
  • Needing to sit closer to the television or computer screen
  • Reduced awareness of people or objects to the sides, above or below (indicating a loss of peripheral vision)
  • Finding it difficult to navigate new places, or asking for help to do so
  • Stumbling and tripping more often

Any young person with visual problems should be seen be a doctor or optician.

If the visual abnormality is accompanied by one or more other symptoms from the HeadSmart symptoms list, an urgent appointment should be made.

If you are a young person and you are concerned about your symptoms, it's best to get them checked out by your GP or optician.

Select for more information about seeing your GP.

If you are a parent or carer of a young person, and you are concerned about their symptoms, explain that you think they should go to the GP or optician and offer to make them an appointment. Bare in mind that, depending on their age and circumstances, they may choose to go to the GP or optician on their own, although many appreciate having a parent or carer with them, whatever their age.

Select for more general information for parents and carers

Be aware

If you are worried about the child, make an appointment with your doctor.
If the symptoms of signs are sudden onset or severe, either take them to the emergency department or call 999