When should children get an eye exam?

By Dr. Robert Ford, OD, Chief of Optometry, Oak Orchard Health

It starts very simply with parents watching their child’s visual behavior. Does your child by 6 months of age look directly at objects and are their eyes working together? Does one eye appear to cross in or wander out to the side while the other eye is straight? Does the front of the eyes look normal in general? 

If parents have any of these concerns, they should discuss them with the child’s pediatrician. The pediatrician is trained to know what is normal and what is not, and he will refer the young child to an optometrist or an ophthalmologist if necessary. 

What’s the impact of schoolwork on your child’s vision?

At Oak Orchard Health, we feel that all children should have a comprehensive vision exam, by an Optometrist or an Ophthalmologist, before entering the first grade. 60-70% of kids do not have a significant vision problem earlier, but it can develop as they go to school. When they come in for their exam, we want to know for sure if both eyes are working together and that the visual acuity (how sharp they see) is acceptable in both eyes. 

We also check how a child functions at close reading distances. Can the child focus easily when objects are near and can they sustain the eye concentration necessary to read or learn to read up close (10 to 20 inches away)?

  It can be a little confusing because children develop at different rates. Some kids have the visual skills to meet the visual demands by the time they are 4 or 5, while other children may not have the necessary skills until they are 6 or 7. This is all very important because even very smart children can perform badly in the classroom all because of vision-related learning problems that can sometimes be hard to detect.

How do you prepare kids for their first eye exam?

Taking young kids to the doctor is always a bit tricky but as they say, honesty is always the best policy. Let your kids know that they are going to sit in a big chair and that the eye doctor is going to look at their eyes. If kids are very young, they often sit on their parent’s laps. Let them know that they will see some pictures or letters, and a light will be shined in their eyes – like a tiny flashlight. Explaining calmly and simply is usually best. 

Sometimes the child does not cooperate, cannot sit still, and will not let the doctor get near their eyes. This is not unusual behavior and is understandable. It is not the child’s fault. Sometimes we must wait a year or so and try again.

At Oak Orchard Health, we try to make these early visits a good experience – as fun as possible. However, sometimes the doctor will have to use dilating drops in order to rule out certain disorders or to determine accurate vision prescriptions.

  “Sometimes I get on the floor with two or three-year-olds and roll a ball to them just to see how their eyes are working. I have some juggling balls I use too. I watch very carefully how they are using their eyes. Are they looking straight? Are they following the objects?” says Dr. Ford. 

An exam can take up to an hour. In our office, if glasses are prescribed, they are usually ordered on the same day.

How does screen time affect children’s vision?

Often you see young kids watching videos or playing games on phones or other hand-held devices. This can cause nearsightedness. To avoid this, you should encourage your children to spend more time outdoors and limit their screen time. It does contribute to changes in their vision and can create eyestrain after a while. We know it is difficult but keeping kids’ screen time low is important. Try to set a limit and stick to it.

Other clues that your child should see the eye doctor?

Constant squinting could mean that they are having a hard time seeing, and would be a reason to go to the eye doctor. If they are closing an eye to see better or moving closer to objects, then a trip to the optometrist is worth it. Eye redness and rubbing are often symptoms of allergies, and you should talk with your pediatrician. 

If you have any questions about your children’s vision, call the Oak Orchard Health Vision Center and we will determine if an eye exam is appropriate.