Some parents may assume that eye testing isn’t possible until their child is verbal or shows signs of vision problems. However, not only do optometrists have specific methods for testing infants and preschool age children, it’s critical that kids have their eyes checked as early as possible.
Why are early exams for children so important?
Let’s talk about why it’s so important, what’s different about a children’s eye exam, and where you can get accessible eye care.
Naturally, you want your child to have good vision. It’s important for their school performance and safety.
But optometrists look at more than how far or clearly a child can see. They also evaluate the eye’s overall health, measure depth perception, how the eyes track and coordinate with each other, and how eyes adjust to changes in vision from near to far.
When your eye doctor can diagnose these problems early, they can often be corrected. For example:
- Lazy eye (amblyopia) – This is decreased vision in one or both eyes without detectable anatomic damage. Eye patching can be used to strengthen the weaker eye.
- Misalignment of eyes (strabismus) – Crossed or misaligned eyes should be treated early in childhood so vision and eye teaming skills can develop normally.
What are the official recommendations for children’s eye exams?
According to the American Optometric Association, children should have their first comprehensive eye exam at six months of age. If there are no vision problems detected, they should have their eyes examined again at age three and just before they enter the first grade (when they’re about five or six).
School-aged children should have an eye exam at least every two years if there’s no vision correction required. Children with eyeglasses or contact lenses should have an exam annually or as recommended by your eye doctor.
How does an eye doctor test an infant’s vision?
To see if your baby's eyes are developing normally, the optometrist will use the following tests:
- Pupil response – Evaluates whether the eye's pupil opens and closes properly in the presence or absence of light.
- Fixate and follow – Determines whether your baby's eyes can fixate on and follow an object such as a light as it moves.
- Preferential looking – Assesses whether your baby’s gaze is attracted more to a striped card versus a blank one.
How does an eye doctor test preschooler’s vision?
Optometrists also have special adaptations for children who cannot yet read.
- LEA symbols – These are like regular eye tests using charts with letters, except they use special symbols including an apple, house, square and circle.
- Retinoscopy – This is a test that involves shining a light to observe the reflection from the back of the eye to determine if there’s any clouding of the lens (congenital cataract) or significant refractive error.
- Random dot stereopsis testing – Using special patterns of dots and 3-D glasses, the doctor measures how well your child's eyes work together
Isn’t the pediatrician or school eye screening enough?
The vision screening conducted by a pediatrician or school nurse only provides limited information on the overall health of your child’s eyes. Only optometrists and ophthalmologists have the advanced training and clinical tools necessary for a thorough evaluation of your child's eyes and vision.
Where can I get free eye testing for my child?
There are several resources in the United States for free children’s exams.
- InfantSEE - This is a public health program run by the American Optometric Foundation. Participating optometrists provide a comprehensive infant eye assessment between 6 and 12 months of age free of charge regardless of family income or access to insurance coverage. You can search for an optometrist by zip code on their website.
- Sight for Students – This is a Vision Service Plan charity that provides free eye exams and glasses to low income, uninsured children who qualify. The program operates nationally through a network of community partners, such as Prevent Blindness Georgia, who identify children in need.
- Children's Health Insurance Program - This is a state and federal partnership that provides low-cost health insurance coverage for children in families who earn too much to qualify for Medicaid but can’t afford private health insurance coverage. In most states, children enrolled in the program may be eligible for free eye exams.
- Medicaid - This is a jointly funded, federal-state public health program administered by each state. Medicaid provides health care coverage to certain low-income people and families who are U.S. citizens. Medicaid pays for several services for eligible children, typically including vision care.
According to a recent study in JAMA Ophthalmology, close to 175,000 American preschoolers struggle with common, untreated vision problems. Make sure your child isn’t one of them by getting a comprehensive eye exam as early as possible. Also, check out our recent blog, "What I Should Eat to Protect My Eye Health."