Eye examinations for children

Eye examinations for children

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Who should check my child's eyes?

The American Academy of Pediatrics, the American Academy of Family Physicians, and the American Association for Pediatric Ophthalmology and Strabismus say that primary care physicians should be the first to screen babies and young children for eye health and vision problems.

If the doctor spots a health problem with your child's eyes, such as a minor infection, she'll treat it. If the problem is more serious, she'll refer you to a medical eye specialist, or ophthalmologist. She should also refer you to a specialist if she notices any other signs of vision trouble, or if there is a family history of eye problems in childhood. If she believes your child may need glasses, she’ll refer you to an optometrist.

When should my child’s eyes be examined?

It's crucial to have your child's eyes checked for problems early on. Good eyesight helps your child do his best in everything from schoolwork to sports. Early detection of certain eye problems, such as lazy eye (amblyopia), makes treatment much more likely to be successful.

The American Academy of Pediatrics and the American Academy of Ophthalmology recommend that your child's eyes be screened for problems at birth, by 6 months of age, at 3 to 4 years of age, at 5 years of age, and every following year.

The recommended schedule set by the American Optometric Association is similar: at age 6 months, at age 3 years, and before first grade, followed by routine exams every two years. (If you go to an optometrist, be sure to coordinate your child's eye care with your pediatrician.)

In addition, if your child has an increased risk of eye disease, his eye care provider might suggest that his eyes be checked more frequently. Factors that might put him at higher risk include premature birth, developmental delay, family history of eye disease, previous serious eye injury or eye disease, use of certain medications, and a chronic condition such as diabetes.

What happens during an eye exam at a well-child visit?

At every well-child visit, the doctor should check for signs of congenital eye conditions or other problems. She should also examine the structure and alignment of your child's eyes and his ability to move them correctly. If the doctor does the following things, you can rest assured she's doing a thorough job:

  • She asks you about your family's vision history (or your child’s birth family history, if he was adopted or conceived through a surrogate).
  • Using a penlight, she examines the outside of your child's eyes, including the eyelids and the eyeball, looking for discharge and other signs of infection, allergy, or disease. She checks to see that the pupils are equal size, round, and reactive to light. She looks to see that the lids don't droop, and checks the position of your child's eyes, lids, and lashes.
  • The doctor checks your child's eye movement by watching his ability to fix on an object (like a toy) and follow it as she moves it into different positions. She'll do this with each eye and with both eyes together.
  • To test your child's vision, she'll watch how he follows an object with one eye and then the other eye (covering one eye at a time). If your child follows the object with one eye but consistently doesn't follow it with the other eye, it's a sign that his vision is worse in the eye that's not responding.
  • When your child is school-aged, the doctor will begin observing the reflection of light from the back of the eyes. In a darkened room (which makes the eyes dilate), she'll use a lighted instrument called an ophthalmoscope to look for a red reflex in each eye and in both eyes at once. An abnormal reaction to light could signal a problem like cataracts (clouding of the lens of the eye) or tumors.
  • For school-aged children, the doctor uses a Snellen eye chart to determine how well your child can see.
  • Although most doctors are trained to screen children for eye problems, some have more training than others. A good pediatrician or family doctor will refer you to a specialist if she notices a potential problem or believes something is out of her area of expertise.

Speak up if your child's doctor doesn't perform an eye exam. Schools sometimes test children's eyesight, so your doctor may assume it's already been done.

How can I make sure that my child's eyes and vision are monitored and cared for properly?

Your first strategy should be to make sure your child's eyes are checked thoroughly at regular doctor visits, as described above. If you're not satisfied, talk with your child's doctor. And if you're still not happy with the level of care, by all means get a second opinion from someone you trust, whether that's another pediatrician, an ophthalmologist, or an optometrist.

Between visits, observe your child's vision at home, and if you think something might be wrong, have it checked out. For pointers on what to look for, see our list of warning signs that there might be a problem with your child's eyes.

What's the difference between an ophthalmologist, a pediatric ophthalmologist, an optometrist, and an optician?

Ophthalmologists are medical doctors who have graduated from medical school and completed, at minimum, an internship and a three-year residency. In addition to doing eye exams and prescribing eyeglasses and contact lenses, ophthalmologists diagnose and treat eye diseases, prescribe medications, and perform surgery.

Pediatric ophthalmologists complete a yearlong fellowship in surgical and medical treatment of eye disease in children after finishing four years of residency training.

Optometrists are not medical doctors but doctors of optometry. They are trained and licensed to examine the eyes and diagnose and treat vision problems with glasses, contacts, and therapy. Optometrists can also prescribe some medications.

Opticians make and dispense glasses and other optical items. They're trained to fill the lens prescription provided by the ophthalmologist or the optometrist, in much the same way that pharmacists fill doctors' prescriptions.

Watch the video: Cameron Optometry Childs Eye Exam (June 2022).