All About Pediatric Eye Exams

Annu­al check-ups with the pedi­a­tri­cian, year­ly den­tist appoint­ments, sports physicals…when it comes to pre­ven­tive care for your child, you do it all. 

But have you remem­bered to get their eyes checked? 

If your child doesn’t appear to have vision prob­lems, it’s easy to put eye health on the back­burn­er. But get­ting your child’s vision checked reg­u­lar­ly is a crit­i­cal part of their well-being. 

Take a look at these FAQs about pedi­atric eye exams. 

What’s the Dif­fer­ence Between Vision Screen­ings and Com­pre­hen­sive Eye Exams? 

First things first. Before sched­ul­ing an appoint­ment, make sure you know the type of care your child needs. 

Vision screen­ings are exams to see if your child needs eye care. They don’t actu­al­ly diag­nose prob­lems – they just let you know if there might be one. Schools pro­vide free screen­ings for chil­dren in cer­tain grades, but your child can also be screened by a pedi­a­tri­cian or eye care provider. 

Screen­ings are a great first step, but they don’t tell the whole sto­ry. That’s where com­pre­hen­sive eye exams come in. These in-depth exams go beyond basic screen­ings to assess your child’s eye health, diag­nose vision or med­ical issues, and pro­vide the right treat­ment if needed. 

Do All Chil­dren Need Com­pre­hen­sive Eye Exams? 

It’s a good idea for all chil­dren to have com­pre­hen­sive eye exams, even if they have had nor­mal screen­ings. Screen­ings don’t check for all types of vision prob­lems, so a com­pre­hen­sive exam might be able to find some­thing that a screen­ing did not. 

Exams can also help providers iden­ti­fy the ear­ly signs of eye dis­eases before they cause vision prob­lems. Find­ing these dis­eases ear­ly makes it much eas­i­er to treat them and pre­vent future vision loss. 

Reg­u­lar eye exams are espe­cial­ly impor­tant if your child has dia­betes. Dia­betes increas­es the risk of devel­op­ing dia­bet­ic retinopa­thy. This is a con­di­tion that can lead to blurred vision, dark or emp­ty spots in vision, or even total vision loss. Ear­ly detec­tion and treat­ment are key to pre­vent­ing vision loss, but dia­bet­ic retinopa­thy doesn’t always cause notice­able symp­toms at first. Reg­u­lar eye exams allow your child’s provider to mon­i­tor their eye health close­ly and catch retinopa­thy ear­ly, ensur­ing time­ly treatment. 

Also read: Annu­al Dia­bet­ic Eye Exam 

How Often Should My Child Get an Eye Exam? 

Through­out most of child­hood, com­pre­hen­sive eye exams should be on the year­ly to-do list. 

What Hap­pens Dur­ing a Vision Screening? 

Vision screen­ings involve sev­er­al steps, including: 

• Using a light to check if your child’s eyes are straight and devel­op­ing normally 
• Tak­ing pic­tures of their eyes to check for the need for glass­es or issues like eye cross­ing or dark spots in the iris (the col­ored part of the eye) 
• Using eye charts with shapes or let­ters to see how well your child can see from far away 
• Assess­ing how well they see col­or to test for col­or blind­ness (this is usu­al­ly only done once)

Even if your child can’t read or speak yet, their provider can still eval­u­ate their vision by see­ing how they respond when cov­er­ing each eye. 

Vision screen­ing looks a bit dif­fer­ent for infants. Your child’s provider will look at how well your baby’s eyes can fol­low a mov­ing object, how their eyes respond to bright lights, if your baby blinks when a light shines in their eyes, and if both eyes focus together. 

You don’t nec­es­sar­i­ly need to take your child to an eye doc­tor for a screen­ing. Dur­ing a well vis­it, their provider may ask if you would like to have your child screened right there in the office. 

At Duly Health and Care, our pedi­atric providers offer in-office vision screen­ing with the GoCheck Kids pho­to­screen­er tool. This tool is con­nect­ed to a smart­phone, it doesn’t require your child’s eyes to be dilat­ed, and the screen­ing is as sim­ple as tak­ing a pho­to of your child. Learn more about the GoCheck Kids photoscreener.

What Hap­pens Dur­ing a Com­pre­hen­sive Eye Exam? 

The com­pre­hen­sive eye exam changes a lit­tle based on your child’s age. Infants (6 months to 2 years) are test­ed for depth per­cep­tion, col­or vision, and how well their eyes can focus. Once they hit those ter­ri­ble two’s, the eye exams become more in depth. 

For chil­dren aged 2 to 5, eye exams test visu­al acu­ity (how well they can see an image or object at a cer­tain dis­tance), abil­i­ty to see col­or, and check for con­di­tions like ambly­opia (com­mon­ly known as ​“lazy eye”). They also look at the health of the dif­fer­ent parts of your child’s eye, such as the pupil and reti­na, and rule out eye prob­lems like glaucoma. 

Com­pre­hen­sive eye exams for chil­dren aged 6 to 18 are very sim­i­lar, but they include some addi­tion­al tests. For exam­ple, their provider might check for hand-eye coor­di­na­tion or their abil­i­ty to use both eyes togeth­er while reading. 

Also read: Should I See an Optometrist or Oph­thal­mol­o­gist? 

Will My Child Need to Have Their Pupils Dilated? 

Dur­ing a com­pre­hen­sive eye exam, your child will like­ly need to have their pupils dilat­ed. This is when the provider puts drops into their low­er eye­lid to make the pupils big­ger. Once the pupils are big­ger, they can see inside of the eyes and get a bet­ter idea of what’s hap­pen­ing in your child’s eyes. For chil­dren aged under 8 years, or patients who can­not con­vey which lens they can see more clear­ly with, dila­tion is the most accu­rate way to mea­sure for glasses. 

Dilat­ing drops can cause blur­ry vision for a few hours, so if your child is going back to school after their appoint­ment, make sure their teacher knows that they might have trou­ble see­ing for a lit­tle while. Also, dila­tion can make peo­ple extra sen­si­tive to light, so you may want to grab a pair of sun­glass­es for your child. 

If your child is ner­vous about get­ting eye­drops, let them know they may feel a tiny bit of burn­ing or sting­ing, but reas­sure them that it will go away after a few seconds. 

What Types of Prob­lems Can Eye Exams Find? 

Eye exams can help a provider dis­cov­er many types of eye and vision prob­lems. Some of the most com­mon eye con­di­tions in chil­dren are: 

• Myopia (near­sight­ed­ness), where they can see things close up but have trou­ble see­ing objects that are far­ther away 
• Hyper­opia (far­sight­ed­ness), where they can see dis­tant objects more clear­ly than they can see close ones 
• Astig­ma­tism, when parts of the eye called the cornea and lens are abnor­mal­ly shaped 
• Ambly­opia (lazy eye), where one eye is stronger than the other 
• Stra­bis­mus (crossed eyes), where both eyes do not focus on the same object at the same time

Also read: Reti­nal Con­di­tions and Treat­ment Options 

Whether it’s your child’s first exam or they’re an old pro, our team is here to answer your and your child’s ques­tions about pedi­atric eye exams. Learn about com­pre­hen­sive pedi­atric eye care at Duly Health and Care and sched­ule an appoint­ment with an oph­thal­mol­o­gist online.