Eye movements in children: characteristics in typical and atypical development and assessment in practice

An efficient and coordinated oculomotor control is vital in the classroom environment. It allows pupils to perform rapid, accurate saccades during reading, scanning a page and exploring a scene or the surrounding space. Further this control facilitates accurate smooth pursuits to follow the teacher’s movements through a variety of teaching routines, and playground activities such as children running or balls rolling. Hence, eye movement deficits or difficulties have the potential to impact children’s development and learning significantly. This review outlines the importance of appropriate eye movement control in children, and describes the typical characteristics of fixational, saccadic and smooth pursuit eye movements, and their development during childhood to achieve adult values. Following this, an introduction to the different eye movement characteristics found in children with learning difficulties is presented, in order to raise optometrists’ awareness of the increased risk of eye movement deficits in populations with atypical or different development. The article also describes and discusses the clinical techniques currently available to evaluate fixations, saccades and smooth pursuits in optometric practice, and provides some recommendations to support optometrists when assessing eye movements in children. Finally, the potential contribution of eye-tracking technologies for clinical practice is presented, and their technologies' limitations and current challenges are discussed.