Pediatric Eye Exams

Regular eye exams are important for children since their eyes can change significantly in as little as a year as the muscles and tissue develop. Good eyesight is critical for a child’s life and achievements since success in school is closely tied to eye health. School demands intense visual involvement, including reading, writing, using computers, and blackboard/smartboard work. Even physical activities and sports require strong vision. If their eyes aren’t up to the task, a child may feel tired, have trouble concentrating, have problems in school or have difficulty playing their favorite games which may affect their overall quality of life.
 
A vision screening provides a limited perspective on the overall health of your eyes. It’s a bit like getting your blood pressure checked and not getting the rest of your annual physical. You’ll have useful information, but it’s not the whole picture.
 

What are the Limitations of a Vision Screening?

Vision screenings only test your ability to see clearly in the distance. This is called visual acuity and is just one factor in your overall vision. Others include color vision, peripheral vision, and depth perception. The screening also doesn’t evaluate how well the eyes focus up close or work together. Most importantly, it doesn’t give any information about the health of the eyes.
 

Vision screenings are conducted by individuals untrained in eye health.

Vision screenings are offered in many places – schools, health fairs, as part of a work physical or for a driver’s license. Even if your physician conducts the screening, he/she is a generalist and only has access to a certain amount of eye health training. Most individuals don’t have the tools or knowledge to give you a complete assessment of your vision or eye health.
 

Vision screenings use inadequate testing equipment.

In some cases, a vision screening is limited to an eye chart across the room. Even when conducted in a physician's office, they won’t have the extensive testing equipment of an eye doctor. They also won’t be aware of nuances such as room lighting and testing distances all of which are factors that can affect test results.
 

When to Perform a Pediatric Eye Exam?

The American Optometric Association (AOA) suggests a strategic eye exam schedule for optimal visual health. Babies should be checked at 6-12 months or as recommended. Children between the ages of 3-5 need at least one eye exam. Ages 6-17 should have an eye exam before first grade, followed by annual eye exams. This exam schedule aligns with AOA guidelines, ensuring early detection and intervention for sustained eye health at every stage.

Small Wonder Eyecare offers free eye exams for babies aged 6-12 months. Vision is important to help your baby develop. Getting their eyes checked early gives them the best chance for success. Babies can’t tell us when they have a problem with their eyes. That’s why it is important to have Dr. Bontrager check to make sure their vision develops correctly. This examination includes tests of pupil responses to evaluate whether the pupil opens and closes properly in the presence or absence of light, a fixate-and-follow test to determine whether the baby can fixate on an object such as a light and follow it as it moves, and a preferential looking test which uses cards that are blank on one side with a picture  on the other side to attract the gaze of an infant, thus assessing vision capabilities. Infants should be able to perform this task well by the time they are 3 months old.

Preschoolers’ visual acuity and eye alignment should be assessed when they are 3 years old. If the child is diagnosed with misaligned eyes (strabismus), "lazy eye” (amblyopia), refractive errors (astigmatism, myopia, hyperopia), or any other focusing problems, it’s important to begin treatment as soon as possible to ensure successful vision correction and lifelong benefits.

At school age or upon entering school, the child’s eyes should be screened for visual acuity and alignment. In this age group, nearsightedness (myopia) is a common refractive error and can be corrected with eyeglasses.

There are some signs that parents can tell if their child has a vision problem. For example, the child may squint, hold reading materials very close to their face, or complain about things appearing blurry. However, there are some less obvious signs that may indicate vision problems, such as having a short attention span, quickly losing interest in games, projects or activities that require using their eyes for an extended period of time, or losing their place when reading. As well as choosing to avoid reading, drawing, playing games or doing other projects that require focusing up close. Another sign is that a child may turn his or her head to the side when looking at something in front of them. This may be a sign of a refractive error, including astigmatism, so by turning their head helps the child see better.

That’s why it is so important for kids to have regular eye exams with an optometrist. The earlier a vision problem is found and treated, the better off your child will be in and out of school.