When Should My Child Have Their First Eye Exam?

December 07, 2016

Early detection of any vision problems is crucial, as children respond best to early treatment. The American Academy of Ophthalmology and the American Association for Pediatric Ophthalmology and Strabismus recommend the following exams:

For newborns, an ophthalmologist, pediatrician, family doctor or other trained health professional should examine a newborn baby’s eyes and perform a red reflex test (a basic indicator that the eyes are normal). An eye doctor should perform a comprehensive exam if the baby is premature or at high risk for medical problems for other reasons, has signs of abnormalities, or has a family history of serious vision disorders in childhood.

Infants should have their first eye exam between 6 months and their first birthday. Between the ages of 3 and 3½, a child’s vision and eye alignment should be assessed by a pediatrician, family doctor, ophthalmologist, optometrist, orthoptist or person trained in vision assessment of preschool children. Some states mandate that a child have an eye exam before entering school for the first time. Most of the time, the initial screenings are done at routine pediatric visits. If issues are noticed, the pediatrician will refer them to an opthamologist. Once children have started school, the AOA recommends exams every two years for children who do not require vision correction, and annual check ups for those who do.

Eye health is crucial during the developmental phases of childhood, as good eyesight is crucial to learning several fundamental life skills such as:

  • Binocular (two eyes) coordination
  • Eye movement skills
  • Focusing skills
  • Peripheral awareness
  • Hand-eye coordination

What to Expect

When your child has their first eye exam, either at their pediatrician’s office or an eye doctor’s office, the doctor should do the following:

  • Check for signs of congenital eye conditions or other problems
  • Ask about your family history
  • Use a penlight to examine eyelids and eyeballs for any discharge, as well as inspect the pupil
  • Check eye movement by asking the child to watch an object. This is usually done with both eyes, and then one at a time
  • For school aged children, use a Snellen eye chart to gauge how well your child can see

What to Look For

There are a few common eye problems that are caught during childhood. Your doctor will screen for these, but if you notice any of the symptoms, you should schedule an appointment to have them checked.

  • Amblyopia, or “lazy eye”– If your child seems to see out of one eye better than the other, you should schedule an appointment with your eye doctor.
  • Strabismus– in this condition, the eyes point in two different directions. This may occur only some of the time, or all of the time. Your child may try to tilt their head to see better.
  • Ptosis- with this condition, a drooping eyelid may cause vision problems. Some children are born with this, while others develop is as they get older.
  • Myopia, or nearsightedness– Just like adults, children can also have a hard time seeing far away objects. If you have a family history of nearsightedness, your child may become nearsighted as they grow. Be sure to mention your family history to your doctor.

Be sure to also tell your doctor if your child has or you have noticed any of these things:

  • A history of prematurity
  • Delayed motor development
  • Frequent eye rubbing
  • Excessive blinking
  • Failure to maintain eye contact
  • Inability to maintain a gaze (fixation) while looking at objects
  • Poor eye tracking skills
  • If your child has failed a vision screening at school or during a visit to his or her pediatrician

A child who cannot see the board in school may become frustrated, and academic performance may slip without them realizing what is wrong. Your child’s eye health should be monitored throughout their lives, with routine appointments to check for vision changes.

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