Parent's Guide

Eye examinations for children are as unique as they are. A child’s growth and development stages play a large role in their vision, something the optometrist will consider during the examination.

The American Optometric Association recommends that a child has his first professional eye examination at age six months, another at age three, one when the child starts school, and then at least every two years thereafter.

In some cases, the examining optometrist may recommend earlier or more frequent examinations based on the child’s needs. Infants and toddlers should be seen earlier if parents note such conditions as crossed eyes or congenital cataracts, if behavior indicates a possible vision or vision perception, or if the child is considered at risk for ocular problems. “At risk” conditions include:

  • Family history necessitating eyeglass wear prior to age three
  • Family history of strabismus (eye turn)
  • Cerebral Palsy, Down Syndrome or other syndromes associated with vision problems
  • Premature birth
  • Manifestations of delays in development

Preparing Your Child for the First Eye Examination

The following list will be useful when preparing your child for its first eye exam.

  • Consider taking your child along with you when you get your eyes examined.
  • Read the book “Arthur’s Eyes” by Marc Brown to your child.
  • Since various instruments utilizing lights will be needed during the examination, play flashlight games with your child. Include some activities that require you to get close to your child with a flashlight without shining it directly into his eyes.
  • Pictures may be utilized if your child does not know numbers or letters. Flashcard games may be played at home in preparation for this activity. Utilize simple stick figure pictures of black and white objects to perform this simulation act.
  • Play “pirate games” to get your child accustomed to having one eye covered.

The Examination

The earlier a child’s vision problems are detected, the more responsive the visual system will be to treatment, and you will be ensuring your child has the best possible vision skills to learn.

The Exam Before Age 1

The American Optometric Association and Pennsylvania Optometric Association recommend that children should have their first eye examination by an optometrist at six months of age. Why? Because your optometrist will examine the eyes for disease and normal eye structure development. Infants will be checked for possible signs of amblyopia (lazy eye), crossed-eyes and other focusing problems. Early detection is often critical in preventing vision problems that can have lifelong effects.

Parents should tell the optometrist about their observances of the child’s general behavior; anything exceptional about the child’s birth, including premature delivery or complications; and milestones in the child’s developmental history, including ages when the child first sat up, crawled, walked, and so forth.

The Exam At Age 3

At age 3, your child’s visual acuity and eye health will be assessed. Eye movement skills, focusing and binocular vision skills (the ability of the two eyes to work together as a team) will be evaluated. The eyes will again be checked for warning signs of amblyopia, which is most responsive to treatment if diagnosed by the age of 3.

The Exam at Age 5

At age 5, your child should be examined to determine the readiness of vision skills for school. An estimated 10% of children have a significant need for eyeglasses to treat nearsightedness, farsightedness or astigmatism. Approximately 15-20% suffer from poor vision skills — focusing, eye alignment or other eye movement skills. Sending a child to school with undetected vision problems can lead to difficulty with learning and frustration in school.

Do Children’s Vision Screenings Substitute for a Comprehensive Eye Exam from an Optometrist?

No. The purpose of a school vision screening is to detect gross visual problems to determine if there is an immediate need for a comprehensive vision examination. All children should have regular comprehensive vision exams. Good vision is more than just 20/20 sight. Efficient vision requires a number of critical visual skills. Some of these skills are eye teaming, clear and sustained near vision, tracking, focusing, and accurate eye-hand coordination. Recognizing the shortcomings of vision screenings, the National PTA passed a resolution to educate its members, school personnel and the public at large about learning-related visual problems and recommend expanded school vision screenings to identify more at-risk kids.