Pediatric Eye Exams

According to experts, about 80% of learning is visual, which means that if your child has trouble seeing clearly, their learning can be affected. The same is true for infants, who develop and learn about the world around them through their sense of sight. To make sure your children have the visual resources they need to grow and develop normally, their eyes and vision should be checked by an eye doctor at key stages of their development.

The American Optometric Association (AOA) recommends that children have their eyes examined by an eye doctor at 6 months, at 3 years, at the start of school, and then at least every two years afterward. If there are any signs of a vision problem, or if the child has certain risk factors — such as developmental delays, premature birth, crossed or lazy eyes, family history or previous injuries — more frequent exams are advised. A child who wears eyeglasses or contact lenses should have their eyes examined every year, since children's eyes can change rapidly as they grow.

Infants: Birth – 24 Months

A baby's visual system develops gradually over the first few months of life. They have to learn to focus and move their eyes and to use them together as a team. The brain also needs to learn how to process the visual information from the eyes in order to understand and interact with the world. Along with the development of eyesight comes the foundation for motor development, such as crawling, walking and hand-eye coordination.

You can help ensure that your baby is reaching milestones by keeping an eye on their development and by scheduling a comprehensive infant eye exam at 6 months. At this exam, the eye doctor will check that your child is seeing properly and developing on track, and will look for conditions that could impair eye health or vision — such as strabismus (misalignment or crossing of the eyes), farsightedness, nearsightedness or astigmatism.

Because there is a higher risk of eye and vision problems if your infant was born prematurely or is showing signs of developmental delay, your eye doctor may recommend more frequent visits to monitor their progress.

Preschool Children: 2–5

The toddler and preschool years are a period of dramatic growth in intellectual and motor skills. During this time, children develop the fine motor skills, hand-eye coordination and perceptual abilities that prepare them to read and write, play sports and take part in creative activities such as drawing, sculpting or building. All of this depends on good vision and healthy visual processes.

This is the age when parents should watch for signs of lazy eye (amblyopia), where one eye does not see clearly, or crossed eyes (strabismus), where one or both eyes turn inward or outward. The earlier these conditions are treated, the higher the success rate. Parents should also be aware of any developmental delays involving object, number or letter recognition, color recognition or coordination, as the root of such problems can often be visual. If you notice your child squinting, rubbing their eyes frequently, sitting very close to the TV or reading material, or avoiding activities such as puzzles or coloring, it is worth a trip to the eye doctor.

School-Aged Children: 6–18

Undetected or uncorrected vision problems can cause children and teens to struggle academically, socially, athletically and personally. If your child is having trouble in school or after-school activities, there could be an underlying vision problem. Proper learning, motor development, reading and many other skills depend not only on good vision but also on the ability of the eyes to work together. Children who have difficulty focusing, reading, teaming their eyes or with hand-eye coordination often become frustrated and may show behavioral problems as well. Frequently they do not realize that the vision they experience is abnormal, so they cannot express that they need help.

In addition to the symptoms described above, signs of vision problems in older children include:

• Short attention span
• Headaches
• Frequent blinking
• Avoiding reading
• Tilting the head to one side
• Losing their place often while reading
• Double vision
• Poor reading comprehension

The Eye Exam

In addition to basic visual acuity (distance and near vision), an eye exam may assess the following visual skills that are needed for learning and mobility:

• Binocular vision — how the eyes work together as a team
• Focusing
• Peripheral vision
• Color vision
• Hand-eye coordination
• Tracking

The doctor will also examine the area around the eye and inside the eye to check for any eye diseases or health conditions. You should share any relevant personal history about your child, such as premature birth, developmental delays, family history of eye problems, eye injuries or medications the child is taking. This is also the time to raise any concerns or issues your child has that might point to a vision problem.

If the eye doctor determines that your child has a vision problem, they may discuss a number of therapeutic options — such as eyeglasses or contact lenses, an eye patch, vision therapy or Ortho-k — depending on the condition and the doctor's specialty. Because some conditions are much easier to treat when caught early, while the eyes are still developing, it is important to diagnose any eye and vision issues as soon as possible.

Following the guidelines for children's eye exams and staying alert to any signs of vision problems can help your child reach their full potential.