Does my child need an eye exam?

Sarah Williams, OD, a pediatric optometrist at NECO’s Eye Care Center, answers questions parents or caregivers frequently have about children’s eye exams.

Baby’s first…eye exam?

Of all the milestones in a baby’s first year, an eye exam isn’t usually at the top of the list—or even on the list at all. But Dr. Williams recommends following the American Optometric Association’s guidelines and scheduling that first exam between six and 12 months old. 

This should be a comprehensive exam that includes a dilation, to assess the health of the eye as well as any vision or eye alignment problems. If everything checks out okay, the next exam should be between ages 3 and 5, or before the child starts kindergarten, and every one to two years after that.

Is there anything I should be watching for?

Along with more obvious problems like a turned eye, if your child is squinting, holding objects close to their face, favoring one eye, consistently turning their head to look at something, or not seeing objects well, it’s time to make an appointment. If your child is not reaching all age-appropriate developmental milestones, definitely schedule a comprehensive eye exam.

Older children may complain of headaches, avoid reading, or struggle in school, but Dr. Williams points out that children may not tell you if their vision is blurry because what they’re seeing is normal to them. A family history of a turned eye or high prescription also warrants early and regular appointments.

doctor examines a baby's eyes while baby sits on woman's lap in exam room      Young child in optometry chair with glasses smiling toward parent.
Does my child need to see a pediatric optometrist?

Pediatric optometrists typically have more training and experience testing for children’s issues. While all optometrists are qualified to examine children, pediatric optometrists are usually more comfortable performing objective evaluations—testing without feedback from the patient—especially important with young children who aren’t yet talking or reading. 

Dr. Williams recognizes that not everyone has access to a pediatric optometrist, but particularly in cases where the child is experiencing vision or developmental problems, it’s worth trying to find one if possible. 

“There are a lot of great primary care optometrists that see children,” she emphasizes, “but pediatric optometrists typically have more experience evaluating more functional aspects of vision (eye teaming, eye tracking, eye focusing) as opposed to just the health and glasses prescription part.”

My child passed their school screening. Do they still need an eye exam?

The short answer is yes. Vision screenings, whether at school or a pediatrician’s office, are fine for picking up certain problems like a high or asymmetric glasses prescription. Yet, they’re only meant to flag issues so the child can be referred to an eye doctor for further evaluation. Unfortunately, screenings often miss a large amount of farsightedness and are unable to evaluate the health of the eye or things like binocular vision status (how well the eyes are working as a team). A child might see 20/20 but still have vision issues; a comprehensive exam done by an optometrist will catch more issues with both vision and the eye itself. 

The earlier a child’s vision issues can be identified and addressed, the more likely a successful outcome can be reached. “When in doubt,” Dr. Williams advises, “schedule a comprehensive eye exam with an optometrist.”