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Children's vision is often overlooked. It is harder for children to describe their vision in a way that adults understand. Unless... You know what you are listening for.

As a child’s eyes develop, it is not uncommon for a number of problems to occur. Beyond blurred vision due to refractive error including nearsightedness (myopia) and farsightedness (hyperopia), children can develop a number of other visual and perceptual problems that are often not detected by a simple vision exam.

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If your child is having difficulty in school or with homework,
it may be their eyes.

According to experts, 80% of learning is visual, which means that if your child is having difficulty seeing clearly, his or her learning can be affected.

To ensure that 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 certain stages of their development.

The AOA recommends that children who wear eyeglasses or contact lenses should have their eyes examined at least every 12 months or according to their eye doctor's instructions.

Why is an eye exam so essential for children before they start school?

Children Eye Exam

Visual Skills for Learning

Early eye tests also are necessary due to the fact that kids need the following basic visual skills for learning:

  • Near vision
  • Distance vision
  • Eye teaming (binocularity) skills
  • Eye motion skills
  • Focusing skills
  • Peripheral awareness
  • Eye/hand coordination

Due to the value of good vision for learning, some states require an eye examination for all youngsters going into school for the first time.

Children Eye Exam

Scheduling Your Child’s Eye Exam

Your family physician or pediatrician likely will be the first medical professional to assess your child’s eyes. A recommendation may be made to an eye doctor or optometrist for further examination if eye problems or eye diseases are suspected during routine physical assessments. Eye doctors have specific devices and training to assist them in detecting and diagnosing potential vision issues.

When scheduling an eye test, choose a time when your youngster is generally alert and calm. Specifics of how eye tests are performed depend upon your youngster’s age, however an examination generally will include a case history, vision screening, determination of whether glasses are required, testing of eye positioning, an eye wellness examination and a meeting with you regarding the findings.

Children's Eye Exam Fully Explained here...

After you’ve made the appointment, you might receive a case history form by mail, or you may be given one when you arrive at the doctor’s office. The case history form will inquire about your child’s birth history (also called perinatal history), such as birth weight and whether the child was full-term. Your optometrist might ask about any complications during the pregnancy or delivery. The form will also ask about your child’s medical history, including present medications and previous or current allergies.

Be sure to tell your optometrist if your youngster has a history of prematurity, delayed motor development, takes part in frequent eye rubbing, blinks often, fails to keep eye contact, can’t maintain a gaze (fixation) while looking at stationary objects, has poor eye tracking abilities or has failed a pediatrician or pre-school vision screening.

Your London, ON optometrist will want to know about previous eye diagnoses and treatments for your child, such as surgeries, glasses or contact lens wear. Be sure you notify your eye doctor if there is history in the family of eye troubles requiring vision correction, such as farsightedness or nearsightedness, misaligned eyes (strabismus) or amblyopia (“lazy eye“).

Eye Exams in Infants: Birth - 24 Months

Infants and toddlers should undergo their first eye examination between the ages of 6 and 9 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 use them together as a team. The brain also needs to learn how to process the visual information from the eyes to understand and interact with the world. With the development of eyesight, comes also the foundation for motor development such as crawling, walking and hand-eye coordination.

Eye testing for babies

It takes some time for a baby’s vision abilities to become apparent. To assess whether your infant’s eyes are developing properly, your eye doctor might use one of the following tests:

  • Tests of pupil responses examine whether the eye’s pupil opens and closes appropriately in the presence or absence of light.
  • “Fixate and follow” testing determines whether your baby can fixate on things (such as a light) and follow it as it moves. Babies should have the ability to accomplish this task well by the time they are 3 months old.
  • Preferential looking includes the use of cards that are blank on one side with stripes on the other side to attract the gaze of a baby to the stripes. In this way, vision capabilities can be evaluated.

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

Since there is a higher risk of eye and vision problems if your infant was born premature or is showing signs of developmental delay, your eye doctor may require more frequent visits to keep watch on his or her progress.

Eye Exams in Preschool Children: 2 - 5 Years Old

Preschool children should undergo at least one eye examination between the ages of 2 and 5 years.

The toddler and preschool age is a period where children experience drastic growth in intellectual and motor skills. During this time they will develop the fine motor skills, hand-eye coordination and perceptual abilities that will prepare them to read and write, play sports and participate in creative activities such as drawing, sculpting or building. This is all dependent upon good vision and visual processes.

This is the age when parents should be on the lookout for signs of lazy eye (amblyopia) - when one eye doesn’t see clearly, or crossed eyes (strabismus) - when one or both eyes turns inward or outward. The earlier these conditions are treated, the higher the success rate.

Parents should also be aware of any developmental delays having to do with 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 his eyes frequently, sitting very close to the TV or reading material, or generally avoiding activities such as puzzles or coloring, it is worth a trip to the eye doctor.

Eye testing for pre-school children

If they don’t yet understand the alphabet or are too shy or too young to answer the physician’s questions, pre-school youngsters can still have their eyes completely tested. Common eye tests generally used for young children include:

  • LEA Symbols for young children are similar to routine eye tests making use of charts with letters, except that special symbols in these tests include an apple, house, circle and square.
  • Retinoscopy is a test that involves shining a light into the eye and observing how it reflects back from the retina (the light-sensitive inner lining of the back of the eye). This test helps optometrists determine the child’s glass prescription.
  • Random Dot Stereopsis makes use of dot patterns to figure out how well the two eyes work as a team.
Eye Exams in School-Aged Children: 6 - 18 Years Old

School-aged children, ages 6 to 19 years, should undergo an eye examination annually to ensure optimal visual acuity and learning.

Undetected or uncorrected vision problems can cause children and teens to suffer academically, socially, athletically and personally. If your child is having trouble in school, or during after school activities, there could be an underlying vision problem. Proper learning, motor development, reading, and many other skills are dependent upon not only good vision, but also the ability of your eyes to work together.

Children that have problems with focusing, reading, teaming their eyes or hand-eye coordination will often experience frustration, and may exhibit behavioral problems as well. Often they don’t know that the vision they are experiencing is abnormal, so they aren’t able to express that they need help.

Symptoms of Vision-Related Learning Problems

In addition to the symptoms written 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 Pediatric Eye Exam

In addition to basic visual acuity (distance and near vision) an eye exam may assess the following visual skills that are required 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 tell the doctor any relevant personal history of your child such as a premature birth, developmental delays, family history of eye problems, eye injuries or medications the child is taking. This would also be the time to address any concerns or issues your child has that might indicate a vision problem.

Eye and vision problems that impact children

Besides looking for nearsightedness, farsightedness and astigmatism (refractive errors), your optometrist will be assessing your youngster’s eyes for indications of these eye and vision issues typically found in kids:

  • Amblyopia. Frequently called “lazy eye,” this is reduced vision in one or both eyes in spite of the absence of any eye health issue or damage. Often amblyopia is caused by strabismus (see below) and a significant difference in the refractive errors of the two eyes. Treatment of amblyopia could include covering the dominant eye to strengthen the weaker eye.
  • Strabismus. This is misalignment of the eyes, typically triggered by a congenital defect in the positioning or strength of the muscles that are connected to the eye and which regulate eye positioning and motion. Left without treatment, strabismus can cause amblyopia in the misaligned eye. Depending upon its cause and extent, surgical treatment could be needed to treat strabismus.
  • Convergence insufficiency. This is the inability to keep the eye easily aligned for reading and other close jobs. Convergence insufficiency can typically be treated effectively with vision therapy, a particular program of eye exercises.
  • Focusing issues. Children with focusing problems (also called accommodation problems) may have trouble altering their focus from distance to near and back once more (accommodative infacility), or have issues keeping enough focus for reading (accommodative insufficiency). These issues can often be effectively treated with vision therapy.
  • Eye teaming problems. Lots of eye teaming (binocularity) issues are more subtle than strabismus. Insufficiencies in eye teaming skills can cause problems with depth perception and coordination.

If the eye doctor does determine 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. Since some conditions are much easier to treat when they are caught early while the eyes are still developing, it is important to diagnose any eye and vision issues as early as possible.

Following the guidelines for children’s eye exams and staying alert to any signs of vision problems can help your child to reach his or her potential.

Children's Vision Problems

Children's Vision Problems

Some experts estimate that approximately 5% to 10% of pre-schoolers and 25% of school-aged children have vision problems.

According to the Canadian Association of Optometrists (CAO), all children should have their eyes examined between 6 and 9 months of age, another exam before they start school, and an annual exam thereafter.

Children without vision problems or risk factors for eye or vision problems should then continue to have their eyes examined at every year throughout school. Children with existing vision problems or risk factors should have their eyes examined more frequently.

Common risk factors for vision problems include:

  • premature birth
  • developmental delays
  • turned or crossed eyes
  • family history of eye disease
  • history of eye injury
  • other physical illness or disease

Children Eye Exam

Children's Eye Exams & Eye Care

Undetected or uncorrected vision problems can cause children and teens to suffer academically, socially, athletically and personally.

If your child is having trouble in school or afterschool activities there could be an underlying vision problem.

You should tell the doctor any relevant personal history of your child such as a premature birth, developmental delays, family history of eye problems, eye injuries or medications the child is taking.

This would also be the time to address any concerns or issues your child has that might indicate a vision problem.

Eye doctor, little girl thinking in London, Ontario

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Optometrist, little holding blocks of lego on her eyes in London, Ontario

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