Eye Exams for Children

Girl Receiving Eye Examination

The vision and eye health of your child is of critical importance. As a parent, you may have questions about how to identify any potential vision problems in your preschooler, or when is an appropriate age for your child’s first eye exam. There are many tips and guidelines to help you in navigating the health and care of your child’s vision.

The American Optometric Association (AOA) recommends infants should receive their first comprehensive eye exam at six months old. It is also recommended to have an additional exam at 3 years of age, and when they enter first grade, at about 5 or 6 years.

Eye exams are incredibly important, as many vision problems can manifest at a young age. The AOA states 25 percent of students starting school have some form of visual problem. If your child does not need vision correction, they should continue to have an eye exam every two years. If your child needs glasses or contacts, exams should occur annually or as recommended by your optometrist or ophthalmologist.

Eye exams are important in establishing good visual health and clear vision. Visual learning accounts for a large portion of how new information is processed and taught, and also integral to other modes of learning. It is important to check your child has the following basic skills related to good eyesight and learning: near vision, distance vision, two-eyes coordination, eye movement, focusing skills, peripheral awareness, and hand-eye coordination.

First Eye Examinations

Infant Eye Examination

In all likelihood, your family physician or pediatrician will be your child’s first professional eye examiner.

If any problems are suspected during routine visits, a referral may be made for further evaluation. Eye doctors and specialists have more equipment and training to identify and diagnose potential vision problems.

When scheduling your first visit, choose a time when your child will be alert and happy. Avoid what is normally nap times, or at the end of long days or stressful events if possible.

The specifics of the examination will vary depending on your child’s age, but a typical exam will include taking a case history, testing your child’s vision, determining if there is a need for eyeglasses, testing your child’s eye alignment, evaluating the overall eye health, and if needed, prescription of eyeglasses.

After you make your appointment, you may be sent a case history form by mail. Nowadays many offices may use digital forms to take a case history, or have you simply fill out the form at the doctor’s office.

The case history will inquire about your child’s birth history or perinatal history, and may inquire about birth weight, whether the child was full term, any complications during pregnancy and delivery, your child’s general medical history, and any allergies.

It is important to disclose to your doctor if your child was premature, if there was any delayed motor development, any frequent eye rubbing, excessive blinking, difficulty with maintaining eye contact or gaze when looking at objects, and / or poor eye tracking skills. If your child has had any previous eye problems, it’s important to disclose this as well. If there is eye problems in your family history, also provide this information to your doctor.

Infant Eye Testing

By six months of age, infants should see as well as adults in terms of color, depth perception and focusing ability. A doctor will test for pupil responses to see if the eyes open and close appropriately in response to light. They should also check if your child is able to fixate and follow an object with their eyes. Doctors also may utilize cards to test for preferential looking. These cards are blank on one side and have wavy lines on the other to attract the attention of the child without the use of an eye chart.

Preschool Children Eye Testing

Child's Eye Exam

There are many eye tests that eschew the ability to read or know the letters of the alphabet when it comes to eye tests for kids. These tests were also developed with the knowledge that some children are shy and have trouble verbalizing.

One such test is LEA symbols, which replace letters with special symbols such as an apple, house, square, or circle.

The doctor may also perform a retinoscopy, which is a test that involves shining a bright light into the eye to observe reflection from the retina.

Common Child Eye Problems

In addition to nearsightedness, farsightedness, and astigmatism, the following are a few common vision problems for school-aged children.

Lazy eye, or amblyopia, is a decreased vision in one or both eyes. Amblyopia sometimes requires eye patching to strengthen the weaker eye, in addition to glasses for correction.

Misalignment of the eyes, or strabismus, is commonly called crossed eyes or turned out eyes. These problems can stem from different causes, including muscle control issues. Strabismus is a common cause of amblyopia, and needs to be treated early in childhood to promote vision and eye coordination skills to develop normally.

Your child will also be tested for focusing abilities, depth perception and color blindness, as well as the general health of your child’s eyelids. The doctor is looking for any abnormal or infected eyelash follicles, any bumps, or unusual discharges.

Remember to schedule your child’s eye exams, and be vigilant. Children often don’t recognize or realize if they have a vision problem. Your observation, along with regular eye exams, will serve to help ensure they have the best eye health and vision possible.