Why Children Need Eye Exams

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.