Eye Exams for Children

Eye exams for children are extremely important. Experts say up to 25 percent of school-aged children have vision problems that can affect learning.

Also, early identification of vision problems in children is crucial because, if left untreated, some eye problems can cause permanent vision loss.

When Should Kids Have Their Eyes Examined?

According to the American Optometric Association (AOA), a child’s first eye exam should take place at 6 months of age. Thereafter, exams should be performed at age 3, and just before they enter kindergarten or the first grade (age 5 or 6).

For school-aged children, the AOA recommends an eye exam every two years if no vision correction is required. Children who need eyeglasses or contact lenses should be examined more frequently – either annually or according to their eye doctor’s recommendations.

Early eye exams are important because children need the following visual skills for learning:

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

Because of the importance of good vision for learning, some states require an eye exam for all children prior to their first year of school.

Scheduling Your Child’s Eye Exam

Your family doctor or pediatrician might be the first medical professional to examine your child’s eyes. If eye problems are suspected during routine physical examinations, a referral should be made to an eye doctor — an optometrist (OD) or ophthalmologist (MD)– for a comprehensive eye exam.

Tests performed during an eye exam may depend on your child’s age, but a comprehensive exam generally will include a case history, vision testing, determination of whether eyeglasses are needed, testing of eye alignment, an eye health examination and a consultation regarding the findings of the exam.

After you’ve made the appointment, you may be sent a case history form by mail, or you may be given one when you check in at the doctor’s office. The case history form may ask about your child’s birth history, including birth weight and whether or not the pregnancy was full-term. Your eye doctor also may ask whether complications occurred during the pregnancy or delivery. The form may also inquire about your child’s medical history, including current medications and any allergies.

Be sure to tell your eye doctor if your child has a history of premature birth, has delayed motor development, engages in frequent eye rubbing, blinks excessively, fails to maintain eye contact, has trouble maintaining focus, has poor eye tracking skills or has failed a vision screening.

Also, be sure to tell your child’s eye doctor if there is a family history of eye problems, such as nearsightedness, farsightedness, astigmatism, misaligned eyes (strabismus) or amblyopia (“lazy eye”).

Eye Testing for Infants

It takes some time for a baby’s vision skills to develop. To assess whether your infant’s eyes are developing normally, your eye doctor may use one or more of the following tests:

  • Pupil testing to evaluate if your child’s eyes react normally to light.
  • “Fixate and follow” testing to see if your child can focus on an object and follow it as it moves. Infants should be able to perform this task quite well by the time they are 3 months old.
  • Preferential looking involves using sets of cards where one card is blank and the other contains a pattern of lines of varying degrees of width and contrast. Vision is assessed by whether or not the card with the stripes attracts your infant or young child’s attention more than the blank card when both are displayed side-by-side.

Eye Testing for Pre-School Children

Pre-school children can have their eyes thoroughly tested even if they don’t yet know the alphabet or are too young or too shy to answer questions.

Some common eye tests used when examining young children include:

  • A special eye chart that displays familiar objects such as an apple, house, square and circle instead of letters of the alphabet. The young child can identify the objects verbally or point to a matching symbol on a card in their hands.
  • Retinoscopy is a test that involves shining a light into the eye to observe how it reflects from the retina (the light-sensitive inner lining of the back of the eye). This test helps eye doctors determine the child’s eyeglass prescription.
  • Random Dot Stereopsis uses special 3D glasses to determine how well the two eyes work as a team.

Children’s Vision Problems

Besides looking for common refractive errors (nearsightedness, farsightedness and astigmatism) that affect visual acuity, your eye doctor will be examining your child’s eyes for signs of other vision problems, including:

Amblyopia. Also commonly called “lazy eye,” this is decreased vision in one or both eyes despite the absence of any eye health problem or damage. Common causes of amblyopia include strabismus (see below) and a significant difference in the refractive errors of the two eyes. Treatment of amblyopia may include patching the dominant eye to strengthen the weaker eye.

Strabismus. This is misalignment of the eyes caused by a defect in the positioning or strength of muscles that control the position and movement of the eyes or defective neurological control of these muscles. Left untreated, strabismus can cause amblyopia in the misaligned eye. Depending on the severity of strabismus, eye surgery often is required to align the eyes.

Convergence insufficiency. This is the inability to keep the eyes comfortably aligned for reading and other near vision tasks, despite the eyes being straight when looking at distant objects. Convergence insufficiency often can be successfully treated with vision therapy – a prescribed program of visual activities that may or may not require optical aids.

Focusing problems. Children who have problems with focusing (also called accommodation) may have trouble maintaining adequate focus for reading or cannot easily change their focus to see objects at different distances clearly. These problems often can be successfully treated with vision therapy.

Eye teaming problems. Many eye teaming (binocularity) problems are less obvious than strabismus. Deficiencies in eye teaming skills can cause headaches, poor attention span, and problems with depth perception and coordination. Again, vision therapy can be effective for treating these problems.

Making Sure Your Child Is Ready To Learn

Experts say up to 80 percent of information children are expected to learn in the classroom is presented visually.

Scheduling a complete eye exam prior to the start of each school year will ensure your child has the visual skills needed to perform at his or her best.

Article ©2013, Access Media Group LLC. Source: Eye Exams for Children by AllAboutVision.com.

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