Stress is a physical, mental or emotional reaction caused by a change that disturbs or interferes with the body’s normal equilibrium. When children are under stress, they may show changes in behaviour which may include:
Too much stress may affect your child’s vision.
Stress is a physical, mental or emotional reaction caused by a change that disturbs or interferes with the body’s normal equilibrium. When children are under stress, they may show changes in behaviour which may include:
- irritability or moodiness
- withdrawal from activities they used to love doing
- clinginess, being unwilling to let parents out of sight
- crying
- aggressive behaviour
- regression to earlier behaviours such as thumb sucking
- school refusal
- unwillingness to participate in family or school activities
Another way stress affects children is changes in vision, known as Streff syndrome.
Streff syndrome, also known as non-malingering syndrome, has been described as a functional vision problem. It often involves reduced or blurred distance and near vision, poor eye teaming and eye movement capabilities, visual field loss and a reduction in focusing.
Although occurring most often in children of ages 8-14 and 80% of the time in young females, it can occur at any age and time. It is a condition which is mainly exhibited in young children going through periods of emotional or visual stress. The visual system, while still active, is no longer controlled by the child when they are under increased levels of stress. Focusing becomes difficult, a tunnel vision effect in a child’s field of view arises, and it becomes hard for their pupils to function adequately during different light conditions.

Although occurring most often in children of ages 8-14 and 80% of the time in young females, it can occur at any age and time. It is a condition which is mainly exhibited in young children going through periods of emotional or visual stress. The visual system, while still active, is no longer controlled by the child when they are under increased levels of stress. Focusing becomes difficult, a tunnel vision effect in a child’s field of view arises, and it becomes hard for their pupils to function adequately during different light conditions.
Streff syndrome is not an abnormality with the physiology of the eyes. Rather it has been associated with the brain and how it processes what you see.
For that reason, Streff syndrome is considered a type of amblyopia, which is psychogenic and involuntary in nature. Psychogenic means “the origin is in the mind” or more accurately in the parts of the brain that help process vision.

Signs and Symptoms Your Child May Have Streff Syndrome Include…
Why Should Parents Be Concerned?
Streff syndrome has been associated with stress. The fact that your child is under stress is quite concerning. Perhaps your child is dealing with too many activities after school which drains their energy? Stress can also be a red flag for anxiety or bullying.

There’s a kind of stress that is normal and adaptive, then there’s a kind of stress that’s pathological and maladaptive. While everyone experiences stress, too much stress can negatively affect your child in several ways, not just in their vision, and steps have to be taken to address this.
Streff syndrome affects your child’s performance at school when they experience sudden reduction in attention and focus during academic tasks. They may begin to struggle at school and there may be an increase in the amount of mistakes made on homework.
Visually, your child may complain of blurred vision at near and in the distance, sensitivity to light, double vision, or increased clumsiness due to objects not being noticed in your child’s side vision.
How Can We Help?
We’ll perform a thorough binocular vision examination to identify that the symptoms are truly psychogenic and not from significant refractive error or pathology. We will discuss with you the etiology, prevalence, signs and symptoms and treatment of Streff syndrome.
We’ll help you identify the main cause of your child’s stress. It may be visual stress, emotional stress, the pressure of schooling, physical or physiological trauma. Once we’ve established the underlying cause of their stress, we’ll help work out a solution or, if needed, refer you to an allied health professional.
As Streff syndrome is self-limiting and resolves when the stress is reduced, there is no quick cure to rid children of the visual problems. While we wait for spontaneous recovery, we will present management options available to help alleviate the symptoms in the short term.
These management options include: low plus eyewear in the form of reading glasses or multifocals, syntonic light therapy or vision therapy to help increase peripheral awareness in cases of children with reduced fields of vision and vision therapy to help increase focusing and eye movement skills.
Your Child’s Sight is Precious
Good vision is vital for your child’s development, both academically and in their everyday life. Don’t wait for the signs to show up – let our behavioural optometrists help you give your child the best chance at clear, efficient vision.