When Does My Kid Need an Eye Exam?

Your child isn’t born with perfect vision. In fact, newborns can only see large objects and faces. It takes years for the different parts of a child’s eyes to learn to work together.

Vision problems can develop at any age. Routine eye exams can make sure your child’s vision is developing well. 

Let's take a look at when you should schedule eye exams for your child and what you should do if you think your child might not be seeing well. 

When should my child’s vision be tested?

There are certain moments and situations where a vision test is a good idea. Your child should have an eye exam:

• As part of their regular well-child care (routine vision screen)

• If they have a condition that puts them at greater risk for developing low vision

• If there’s a concern about their ability to see

What is a routine vision screening?

A routine vision screen is a vision test that checks for trouble seeing. It’s called a “vision screen” because experts recommend it for all children, even if they don’t have low vision. Healthcare providers do vision screens in their office as part of your child’s yearly checkup.

The American Academy of Pediatrics recommends that all children have a vision screen:

• Every year, from 3 to 6 years old

• At age 8, 10, and 12 

• Once during their mid-teen years (usually 15 years old)

At all checkups, your child’s healthcare provider will do a basic eye exam, too. They will also ask if you have concerns about your child's vision. If you do have concerns they will do a vision screen (if it hasn’t already been done). They might also ask your child to see an eye doctor for a complete eye exam and full vision testing. 

Vision screens are especially important for young children. That's because their vision is still developing. Untreated vision problems in young children can lead to lifelong low vision.

Studies show only 60% of children between 3 to 5 years old get a vision screening. So it’s important to follow up with your child’s healthcare provider or an eye doctor to make sure your child gets screened on time. 

What conditions can affect my child’s vision?

Some conditions can affect vision, including:

• Premature birth

• Trauma to the eye or brain

• Conditions that affect how part of the eye develops

• Conditions that can lead to amblyopia, like a congenital cataracts

• Some neurologic and genetic conditions

• Exposure to certain infections before birth

• Exposure to certain medications, like growth hormone

If someone in your family has a history of amblyopia, your child is more likely to develop it.

If your child has one of these conditions, their healthcare provider may refer your child to an ophthalmologist. An ophthalmologist can fully evaluate your child’s hearing with more precise tools. Their tools can check vision in children of all ages, even young babies.

When should I be concerned about my child’s vision?

Vision problems can develop at any age. Your child may be able to tell you something has changed about their vision. But children who aren’t verbal won’t be able to tell you they’re having changes in their vision. And some children won’t realize they have changes in their vision. So you can’t depend on your child to tell you if they’re having trouble seeing.

Some other signs your child may have trouble seeing include:

• Eyes that don’t follow objects (especially in young infants)

• Eyes that look misaligned (crossed or turned out)

• White or gray color in the pupil

• Eye pain

• Eye redness

• Droopy eyelids

• Light sensitivity

• Unusual eye movements

What are the different types of vision tests?

There are several types of vision screening tests that your child’s healthcare provider will use:

• Photoscreener: A photoscreener is a machine that gives information about your child’s vision and eye health. There are many types of photoscreeners. To use a photoscreener, your child only needs to look at an object in the room while the machine does the rest. 

• Visual acuity chart: A visual acuity chart (or eye chart) has letters, shapes, or objects. The sizes of these objects start larger and then get smaller. Your child stands a certain distance away from the chart and reads each letter or object. To complete this screen, your child has to be able to name the objects, shapes, or letters on the chart. This screen isn’t a great option for some kids, which is why the photoscreener is helpful.

• Eye exam: As part of your child’s eye exam, your child’s healthcare provider will examine your child’s eye using an ophthalmoscope, a type of instrument. They will also check your child’s pupils, eye alignment, and eye movements. An eye exam doesn’t test your child’s vision but gives an overall picture of eye health.