Eye Exams for Children

Eye Exams for Children

Parents often have a lot of questions related to their children and necessary eye care, including whether or not a pre-schooler has vision difficulties. Parents also wonder when they should bring children to visit an eye specialist.

It really goes without saying that regular eye examinations are of extreme importance to your child to ensure healthy vision. According to some research, 25% of children that are school-aged have vision difficulties, and between 5 and 10% of children of pre-school age also have problems with their vision. The sooner a doctor discovers such problems the better it is for the child, as it is possible to eradicate some eye conditions if handled early on in the child’s development. What’s more, there are eye conditions that have the potential for causing serious eye injury, damage, permanent loss of vision, and even blindness.

Eye Examination Planning

As per information shared by the American Optometric Association, it’s advised that parents bring their children to see an eye specialist based on the following schedule:

  • Initial visit and exam: Age 6 months
  • Pre-school examination: Age 3
  • Next eye evaluation: Age 5, just before entry into kindergarten
  • School-aged Children: Require an eye examination every two years
  • Children who have eyeglasses or contacts: An eye examination is necessary every year

Every child has fundamental vision skills required for functioning and learning. Since good vision is imperative for many learning activities, some states mandate that the child have an eye examination before school enrollment. Necessary visual skills imperative to learning include:



  • Awareness (Peripherally)
  • Binocularity: skills where the eyes work as a team and in unison to interpret the external environment
  • Coordination between eyes and hands
  • Eye movements
  • Focusing
  • Near/Distance vision skills


Eye Examination Scheduling

The first person who will evaluate your child and their vision is often the family doctor, primary care physician, or pediatrician. Once a basic examination is completed, if the healthcare provider feels there may be a vision problem requiring additional care, your doctor will refer you and your child to an optometrist or ophthalmologist for an more extensive eye examination. The optometrists/ophthalmologists have the necessary equipment to discover problems with vision and/or diseases of the eye.

It’s important to have your child in a mood where he or she is willing to participate in an eye examination, thus schedule the appointment when your child is typically in a fair mood and cooperative. The type of examination your child will have to have is dependent upon how old your child is at the time of the visit. A visit will require you share information with the vision specialist and vision testing typically follows a gathering of case history information. The specialist will test to see if the eyes are properly aligned if the child needs corrective lenses, and if the eyes are in healthy condition. Once the examination is complete, the doctor tells you of the next step in terms of necessary treatment for your child, if applicable.

In some instances, following the appointment scheduling, you will receive a form via US mail asking for a bit of historical information related to your child’s health. Sometimes your own physician may give you the necessary documentation. Either way, the document is an important one, and you should fill it out to the best of your ability. The form will include questions related to your child’s perinatal (birth) history like whether your child was full term, complications during pregnancy/delivery, and what your child’s birth weight was when born. You will also have offer information relating to your child’s medical history, what medications the child is taking, and if the child has allergies.


If any of the following issues/conditions/events has happened to your child, you must include it on the history form as it can play a role in your child’s eye health:

  • Contact lens/eyeglass use
  • Difficulty with fixation (gazing at objects and maintaining the gaze)
  • Excessive blinking
  • Failed eye exams
  • Familial history of eye condition surgeries like amblyopia (Lazy Eye), strabismus (misaligned eyes), farsightedness or nearsightedness.
  • Familial history of eye conditions leading to the need for corrective eyeglasses or contacts
  • Lack of eye contact
  • Motor development delay
  • Premature birth
  • Prior ocular diagnoses
  • Rubbing the eyes frequently
  • Substandard eye tracking skills
  • Surgical procedures on the eyes

Infants & Eye Testing

After a baby is born the child’s vision will develop gradually over the course of time. When you bring your child to the eye doctor, the physician may conduct one or more tests, including:

  • Pupil Responses: This is an exam the doctor conducts to see if your baby’s eyes close/open correctly when exposed to light and in the absence of it.


  • Fixate and Follow Exam: This is a test to see if your child can fixate their gaze on an object and maintain the gaze as well as follow it with their eyes. The child should have developed this ability by the age of three months.


  • Preferential Looking: This is an examination involving the use of cards with one stripped side and one blank side. The stripped cards capture the interest of the child so the child looks at the card. The cards allow for an easy eye assessment.


Pre-Schoolers & Eye Examinations

A child does not need to have knowledge of numbers or letters in order to take an eye examination. Pre-schoolers, whether too shy or young to speak with the doctor, can still have their eyes examined. Pre-schoolers might have any of the below-mentioned eye examinations:

LEA Symbols Test: This examination involves the use of symbols that the child will recognize and is ideal for a child who is not yet familiar with the letters on standard eye tests. The symbols are easily recognizable too and include a circle, square, house, and apple.

Random Dot Stereopsis: An examination involving the use of patterns made up of dots so the doctor can determine if your child’s eyes are working together as a team.


Retinoscopy: This is an examination of your child’s retina (located in the back of the eye and featuring light-sensitive properties). The doctor will shine a light in your child’s eye to examine each eye and to ensure retina health.


Vision Difficulties in Children

There is an array of conditions that can affect your child’s eyes, thereby making regular eye examinations imperative. When you bring your child to the eye doctor, he or she will check to see if your child has any of the following conditions:

Amblyopia: Also known as Lazy Eye, this is a condition where one or both of the child’s eyes experience a decline in vision, even though both of the eyes are physically healthy. Refractive errors or strabismus causes the condition. To treat the condition, the child may require vision therapy involving eye exercises, drops, and patch wearing over the unaffected eye to strengthen the amblyopic eye.

Convergence insufficiency: This condition results in your child not being able to keep his or her eyes aligned when reading or looking at things up-close. Vision therapy and eye exercises treat the condition.

Eye teaming issues: Binocularity or eye teaming issues are similar to but milder than strabismus. This condition causes problems with coordination and depth perception.

Focusing issues: Sometimes children have issues with focusing (also known as accommodation issues) and, therefore, have difficulty shifting focus from near to far and vice versa (also called accommodative infacility). In other cases, the child may experience accommodative insufficiency: difficulty focusing on reading material. Vision therapy helps in dealing with eye problems related to focus.

Hyperopia: Also known as farsightedness, this is a condition where your child can see things clearly from afar, but has difficulty with viewing things up close.

Myopia: Also known as nearsightedness, this is a condition where your child sees up close but has some vision trouble viewing things from afar.

Strabismus: This condition occurs when the eyes are misaligned and is a congenital defect affecting eye muscle strength and/or positioning leading to issues with eye movement. If not treated, the condition can lead to Lazy Eye in the misaligned eye. If the condition is severe enough, surgery may be necessary in order to treat it.

Learning & Vision

According to researchers, as much as 80% of everything teachers share with your child in the way of lessons requires visual learning skills. Thus, if your child has eye health issues and vision problems, they can negatively affect your child’s learning ability. It is imperative your child receive proper eye care throughout his or her development, including the regular scheduling of eye examinations.


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