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Pediatric Eye Exams

Pediatric Eye Exams

Knowing whether your pre-schooler has an eyesight issue and when to book an appointment are questions a parent may ask.

Up to a quarter of school-aged children have problems with their vision. It is essential that children have eye exams because unidentified vision problems left untreated can lead to long term vision loss.

Watch a short, informative video on kid's vision now.

When should children have their eyes checked?

It is advised by the American Optometric Association (AOA) that infants have their first full eye evaluation at the age of 6 months. They should then have their eyes tested at the age of 3 years and at 5 or 6 before starting school.

If no vision correction is needed, the AOA suggests school-aged children should continue to have their eyes checked every two years during their school years and if eyeglasses or contact lenses are required, to have an annual eye exam or recommended by their doctor.

Early eye exams also are important because children need certain basic visual readiness skills for learning. Some of these include near and distance vision, eye pairing and movement skills, focus, eye/hand coordination and peripheral recognition.

To ensure good vision for learning, certain states obligate all children to have a eye evaluation before beginning school.

Booking your child's eye evaluation

Before going to see an ophthalmologist or optometrist, your child will usually go to a family doctor or pediatrician for a routine check-up. If there are any eye related problems detected, a referral will be made to an optometrist or ophthalmologist to check further. Your eye doctor is trained to recognize any possible vision issues.

An eye exam for your child will usually include taking the basic information about your child's health, an eye health check-up, a vision test to identify if eyeglasses are required, eye alignment testing and an overview of the results.

You will be asked to fill in a case history form either before or when you arrive for the appointment with your child. This form will ask for information about your child's birth history (perinatal history) .i.e birth weight, if your child was born premature, any complications during pregnancy or at birth, medical history, allergies and any past or present medications taken by your child.
If your child has has failed a pediatrician or pre-school vision screening or has developmental delayed motor development, please let you eye doctor know. Children with vision problems tend to rub their eyes blink often and are unable to maintain a gaze (fixation) while looking at objects.
 
It is important to let your eye doctor if other family members need vision correction such as nearsightedness or farsightedness, misaligned eyes (strabismus) and amblyopia ("lazy eye"mis). Your eye doctor will also want to know if your child has had any prior ocular diagnoses and treatments including glasses or contact lens wear and surgeries.

Eye evaluations for infants

A baby's vision skills take time to develop. Your eye doctor may use one or more of the following tests to judge whether your infant's eyes are developing as expected,
 
By the time an infant reaches the age of 3 months old they should be able to complete tasks where vision capabilities can be assessed such as the "Fixate and follow" test which identifies if your baby can fixate on an object and follow it with their eyes, responses of the pupil when opening and closing in the presence or absence of light, the preferential looking test which involves using cards that are blank on one side and have stripes on the opposite side to draw the attention of infant's gaze to the stripes.

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 the doctor's questions. Some common eye tests used specifically for young children include:

  •     LEA Symbols for young children are similar to regular eye tests using charts with letters, except that special symbols in these tests include an apple, house, square and circle. 
  •     Retinoscopy is a test that involves shining a light into the eye to observing 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 dot patterns to determine how well the two eyes work as a team.

Eye and vision problems that affect children

Besides looking for nearsightedness, farsightedness and astigmatism (refractive errors), your eye doctor will be examining your child's eyes for signs of these eye and vision problems commonly found in young children:

  •     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, often caused by a congenital defect in the positioning or strength of muscles that are attached to the eye and which control eye positioning and movement. Left untreated, strabismus can cause amblyopia in the misaligned eye. Depending on its cause and severity, surgery may be required to treat strabismus.
  •     Convergence insufficiency. This is the inability to keep the eye comfortably aligned for reading and other near tasks. Convergence insufficiency can often be successfully treated with vision therapy, a specific program of eye exercises.
  •     Focusing problems. Children with focusing problems (also called accommodation problems) may have trouble changing focus from distance to near and back again (accommodative infacility) or have problems maintaining adequate focus for reading (accommodative insufficiency). These problems often can be successfully treated with vision therapy.
  •     Eye teaming problems. Many eye teaming (binocularity) problems are more subtle than strabismus. Deficiencies in eye teaming skills can cause problems with depth perception and coordination.

Vision and learning

children playing drawingExperts say that 80% of what your child learns in school is presented visually. Undetected vision problems can put them at a significant disadvantage. Be sure to schedule a complete eye exam for your child prior to the start of school. Learn more:

    Watch a short, informative video on kid's vision.
    Read more about pediatric vision care.

Source: Eye Exams for Children, article by AllAboutVision.com. ©2009 Access Media Group LLC.  All rights reserved.  Reproduction other than for one-time personal use is strictly prohibited.

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