Children’s Eye Care: Important Facts for Parents and Caregivers

Does Your Child's Back to School List Include An Eye Exam? It Should

Most parents are used to taking their children to the pediatrician and the dentist for regularly scheduled checkups.   However, many parents don’t realize that their children should also have regular eye exams – even if the child doesn’t wear glasses.  Why?

Eye problems are very common in children.  The American Optometry Association (AOA) estimates that 1 in 4 children has a vision-related condition.  Left untreated, these conditions can have a serious effect on a child’s learning, development, athletic performance, and overall health:

Vision and Eye Health Problems In Children

  • Poor vision directly affects learning.   When a child has difficulty focusing or cannot see things clearly, their learning and attention can suffer.   In fact, the AOA estimates that 60% of learning disabilities are associated with vision problems.  As an aside, that is why when a child is suspected of having ADD/ADHD or another learning disorder, they should be referred for a comprehensive eye exam.
  • Eye problems can affect development.  Not only can poor vision affect learning and behavior, but some eye conditions can affect a child’s physical and neurological development as well.  For example, eye muscle imbalances (called strabismus, or commonly “crossed eyes” or “wandering eyes”) can lead to amblyopia (“lazy eye”) in which the brain suppresses vision from one eye to avoid seeing double.  This can lead to permanent vision loss if untreated.
  • Eye problems can also affect physical abilities and athletic performance.  Vision irregularities or eye muscle imbalances can affect depth perception, leading to “clumsiness,” tripping, and poor hand-eye coordination.
  • While very rare, children sometime experience more serious eye conditions such as cancerous tumors (retinoblastoma, medulloepithelioma), congenital glaucoma, retinal disease, etc. that can cause blindness and even be life-threatening.

Eye Exams: Part of Your Child’s Primary Care Routine

The good news is, most childhood eye conditions can be corrected or effectively treated – especially if they are caught early.   And by far the best way to identify and diagnose these problems is through a comprehensive eye exam.   Unfortunately, many children who should be getting eye exams aren’t getting them.

One reason for this is that some parents still think of the eye doctor as a specialist that you consult only after you notice symptoms of vision conditions in your child.  The problem with this approach is that by the time you notice symptoms, your child is probably already suffering some adverse affects – headaches, learning or behavior problems, or more.   By having regular eye exams, you can catch problems early and usually can head off the negative effects.  That is why you should think of your eye doctor as a primary care physician, just like your pediatrician or dentist.

Why Kids Need Eye Exams, Even If They’ve Passed a Vision Screening

Another reason parents don’t schedule eye exams is that they are lulled into a false sense of security because their child passed a vision screening at school or the pediatrician’s office.  Even when screenings are run by medically trained personnel, they fail to identify 1 in 3 cases.  That means that if your child has an eye or vision problem, there is a 33% chance that a routine screening won’t even notice it.  How can this be?  There is a big difference between a quick screening and a comprehensive eye exam:

  • Screenings are quick while exams are comprehensive.  A screening lasts 3 to 5 minutes; there is a limit to what you can do in such a short time.  By contrast, a comprehensive eye exam lasts 30 to 60 minutes and is thus much more thorough.
  • Screenings are just that… screenings.  They are intended to catch patients with obvious symptoms and refer them for further assessment.  By contrast, eye exams are diagnostic.  They provide a complete assessment of vision and eye health, identifying any problems and the proper course of treatment or evaluation.
  • There are no set standards for who performs a screening.  An eye exam, by contrast, is performed by an eye doctor – an optometrist or ophthalmologist – who has specialized medical training in the eye and who diagnoses and treats eye conditions all day, every day.
  • Vision screenings usually only test for nearsightedness (myopia).  A comprehensive eye exam also tests for farsightedness (hyperopia) and vision distortions (astigmatism).  This is particularly important for children since these latter conditions are less obvious in the classroom, but can affect a child’s ability to read.
  • Vision screenings may not test for eye muscle problems – and if they do, they usually only catch very obvious symptoms.  By contrast, a comprehensive eye exam includes a detailed assessment of the eye muscles, and of related abilities like tracking and depth perception.
  • Screenings typically do not include a medical assessment of the eye.  In particular, they do not examine the inside of the eye where any serious medical conditions would be evident.  By contrast, in a comprehensive eye exam the doctor dilates the patient’s eyes and carefully examines the inside of the eye with a slit lamp.

The bottom line is that comprehensive eye exams are much more effective at identifying problems – including many problems that vision screenings don’t even check for.  That is why most medical and vision insurance companies cover the cost of a routine eye exam as part of normal preventative care.  And it is why three states have now passed laws requiring that school-age children have a comprehensive eye exam performed by an eye doctor (optometrist or ophthalmologist), rather than a vision screening.

Recommended Pediatric Eye Exam Schedule for Children

The AOA recommends that children have a comprehensive eye exam every two years.   More specifically:

  • First 12 months – Infants, particularly premature babies, should have an eye exam in the first 12 months.
  • Age 2 or 3 years – Preschool is a critical time for learning.  Preschoolers should have an eye exam when they are old enough to understand and respond to the exam.
  • Age 5 – Kindergarten is also a critical time for learning.  Kindergartners should have an eye exam before entering school.
  • Children without identified vision problems should then have a comprehensive eye exam every two years.
  • Children who wear glasses or who have other eye conditions should see the eye doctor at least annually, or more often, as recommended by the doctor.

Do you need to schedule an exam for your child?  Do you have any questions about your child’s vision health?  If so, give us a call at 978-443-3021.  We’re here to help.