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Why should I get my child's eyes checked?

Dr. Monica R. Khitri, MD
Ophthalmologist (Eye Specialist)

Children should start getting eye examinations as soon as they are born. Initially, these exams are performed by the pediatrician or primary healthcare provider as a part of a routine well-child visit. They are aimed to detect structural abnormalities of the eye or problems with eye alignment.

As a child gets older, emphasis should be placed on checking visual acuity. For most children, this can be done around age 3 to 4 but, at minimum, should be performed by age 5. This exam can be done by an ophthalmologist, optometrist, pediatrician or other primary healthcare provider.

Regular vision exams are as crucial as hearing exams, blood tests and other standard screenings at a pediatrician’s office, yet sometimes these screenings are not included in a child’s overall physical examination. Eye exams are most important at two points in a child’s life: right after birth and around age 3. When a child’s vision is not screened consistently, eye problems may go undetected until after the opportunity for treatment has been lost.

The sooner vision problems are detected, the sooner corrective therapies can be initiated. Pediatricians are trained to screen for eye problems using the red reflex exam, to check how the pupils react to light, to measure visual acuity in older children and to see if the eyes are approximately aligned.

Our eyes need regular checkups from childhood through our senior years. Most doctors recommend taking your child to an ophthalmologist  for a full exam before they start kindergarten.

Don’t depend on the eye chart that hangs in many school nursing offices to determine whether your child has healthy eyes and good vision. The chart only tests distance vision and doesn’t screen for overall eye health, near vision, color vision and whether eyes work in coordination, focus correctly or can track a moving object.

Dr. Michael X. Repka
Ophthalmologist (Eye Specialist)

All children should undergo an evaluation to detect eye and vision abnormalities during the first few months of life, at 6 months to 1 year, at 3 to 4 years, and at 5 years (approximately). Abnormalities present at birth, such as opacities of the ocular media (e.g., congenital cataract) or ptosis, may have profound effects on the development of the normal vision in the infant. By age 3 1/2, the child will generally cooperate enough for fairly accurate assessment of visual acuity and ocular alignment, and he or she should have this assessed by a pediatrician or other medical practitioner. Any abnormalities or inability to test are criteria for referral to an ophthalmologist. Infants at high risk, such as those with the potential for retinopathy of prematurity and those with a family history of retinoblastoma, childhood cataracts, childhood glaucoma, or metabolic and genetic disease, should have a medical examination by an ophthalmologist as soon as medically feasible.

According to the American Academy of Pediatrics, eye exams should begin at birth and continue at each well-child check. Prior to 3 years of age, the eyes should be examined for ocular motility, or proper eye movement, pupil examination, external lid and eye abnormalities and red reflex looking for cataracts or eye tumors. At the age of 3 years, visual acuity should be assessed and a fundoscopic exam should be attempted to carefully look at the back of the eye.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.