Vision Exams For Children

Most people don't think about their child’s vision unless they have trouble reading the board at school. After all, young eyes are healthy eyes, right? Not necessarily. According to the Vision Council of America, 1 in every 4 children has a vision problem that can interfere with learning and behavior.

If your child hasn't had a comprehensive eye exam, they are not alone. Half of all American children have not had a comprehensive eye exam. Of them, many need glasses and don't even know it. And because 80% of everything children learn comes through their eyes, uncorrected vision problems impact their ability to learn and interact with the world around them.

My child gets vision screenings at school, isn't that good enough?

Children_Eyes.jpg No. Many parents believe that school vision screenings are sufficient care for their children's eyes. But this is not true. Simple eye checks are good for detecting some common problems such as trouble seeing distance. However, they may not catch everything, including astigmatism and blurred vision, just to name a few. Click the link to learn more about the difference between school vision screenings and eye exams from the American Optometic Association.

Children's Vision Development

Infant Vision

As your child grows and develops so will their vision. Your baby's eyes will be checked at birth and during well-baby visits throughout the first year.  All babies should receive a infant's eye exam, which is possible with the InfantSee program.  Babies usually see movement before anything else. Full-term babies should be able to see their mother's facial expression within a week of birth.  Color vision and depth perception aren't yet fully developed and eye muscle coordination is also very immature. Babies often have eyes that are turned in, turned out or not working as a team, a condition known as strabismus. If this problem doesn't resolve itself by the age of three or four months, consult an eye doctor.

Preschooler Vision

From ages 3 to 6, your child will be fine-tuning the vision already developed during the infant and toddler years. Older preschoolers are learning how to use sports equipment and working on the fine motor skills needed to write their names. Watch for the warning signs of visual problems, such as sitting too close to the TV or holding a book too close, squinting, head tilting, eye rubbing and sensitivity to light. Farsightedness and strabismus are common problems with this age group. However, some problems might not have a sign; only an eye doctor can tell.  If your child exhibits no symptoms of a visual problem, he should have a children's eye exam by the age of 3. Having a complete children's eye exam even before the child enters school allows enough time to catch and correct any problems while the visual system is still flexible.  

School Aged Children

School-age children should receive a children's eye exam before entering kindergarten and regularly after that even if they have no visual problems.  If your child requires glasses or contact lenses for refractive errors, schedule visits every 12 months.  A vision screening performed by your pediatrician or the school nurse is not a complete eye exam. These vision screenings are designed to alert parents to the possibility of a visual problem and do not take the place of a visit to the eye doctor. Although helpful, studies show that these vision screenings may miss sight-threatening eye conditions.

Warning Signs and Risks for Vision Problems in Children

  • Squinting, closing or covering one eye
  • Constantly holding materials close to the face
  • Tilting the head to one side
  • Rubbing eyes repeatedly
  • One or both eyes turn in or out
  • Redness or tearing in eyes after reading
  • Developmental delays
  • Family history of lazy eye
  • Frequent headaches
  • Losing place when reading or rereading lines often

Eye and vision problems that affect children

Besides looking for nearsightedness, farsightedness and astigmatism (refractive errors), your pediatric eye doctor will be examining your child's eyes for signs of these eye and vision problems commonly found in young children:

Amblyopia. Also commonly called "lazy eye," this is decreased vision in one or both eyes despite the absence of any eye health problem or damage. Common causes of amblyopia include strabismus (see below) and a significant difference in the refractive errors of the two eyes. Treatment of amblyopia may include patching the dominant eye to strengthen the weaker eye.

Strabismus. This is misalignment of the eyes, often caused by a congenital defect in the positioning or strength of muscles that are attached to the eye and which control eye positioning and movement. Left untreated, strabismus can cause amblyopia in the misaligned eye. Depending on its cause and severity, surgery may be required to treat strabismus.

Convergence insufficiency. This is the inability to keep the eye comfortably aligned for reading and other near tasks. Convergence insufficiency can often be successfully treated with vision therapy, a specific program of eye exercises.

Focusing problems. Children with focusing problems (also called accommodation problems) may have trouble changing focus from distance to near and back again (accommodative infacility) or have problems maintaining adequate focus for reading (accommodative insufficiency). These problems often can be successfully treated with vision therapy.

Eye teaming problems. Many eye teaming (binocularity) problems are more subtle than strabismus.  Deficiencies in eye teaming skills can cause problems with depth perception and coordination.

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