Getting Your Child Ready for an Eye Exam

Many parents wonder when their child needs to have an eye exam. That is a great question!

The good news for parents is that a basic eye exam is part of every well-child visit with the pediatrician or family-medicine doctor. These primary health care providers are trained to evaluate the visual function and external structures of the eye from the very first newborn visit and continuing on throughout childhood. Starting around 6 months of age, the alignment and movement of the eyes are evaluated. Often at 12 months of age, photoscreening devices are used to screen for large refractive errors (glasses prescriptions) that could negatively impact a child learning to see. As soon as a child is able to read an eye chart (usually between 3 and 5 years old), vision testing can be added to the assessment. Vision testing continues in the school system.

Primary care providers and school nurses utilize the basic, screening eye exam to identify children who would benefit from a comprehensive eye exam with an ophthalmologist or optometrist. If your child has failed a vision screening exam, it is important to schedule a complete, dilated eye exam with an eye care professional.

In addition to a failed vision screening, there are several other reasons that a comprehensive eye exam may be needed. It is recommended that your child see an ophthalmologist if he/she:

• Has a medical problem that could affect their eyes such as Down syndrome, a history of prematurity, neurofibromatosis, or juvenile idiopathic arthritis

• Has a family history of eye disease, such as a sibling or parent with amblyopia or strabismus

• Has a learning disability, developmental delay, or neuropsychological condition

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• Has a vision complaint or observed abnormal visual behavior

• Has eye discomfort, redness, or headaches

Now that your child is scheduled for an eye exam, you may be wondering what to expect during the exam–another great question!

Comprehensive eye exams in children involve assessments of the child’s vision, eye movements, and depth perception, as well as the external and internal structures of the eye. Your child’s refractive error (glasses prescription) will also be measured. The exam requires dilation of the pupils to see the eye structures fully and to obtain accurate measurements. In order to complete all components of the exam (including a minimum of 30 minutes for the dilating drops to take effect), you may be at the doctor’s office for up to two hours. It is important to plan your child’s appointment during the time of day that will be best for them.

Pediatric eye care professionals and their staff understand that a complete eye exam may seem scary to children, and they strive to help families feel as comfortable as possible while in the office.

Often, you will start by meeting with the ophthalmologist’s assistant (technician) who will ask questions about your child and your concerns. Following this, your child’s visual function and eye movements will be assessed. These assessments are done differently, depending on your child’s age and development. Sometimes, the ophthalmologist will evaluate your child prior to placement of dilation drops, but often these are placed by the technician prior to seeing the doctor. Once your child is dilated, the doctor will evaluate the structures of your child’s eyes and measure the refractive error (glasses prescription). The doctor will then share the results of the comprehensive eye exam and provide a glasses prescription, if indicated.

After the exam, your child’s eyes may remain dilated for the remainder of the day. Thankfully, symptoms of light sensitivity and blurry vision usually wear off after a few hours. Also, children can wear sunglasses or a hat for comfort while their eyes return to normal, but these are not required. While it is safe and encouraged for children to return to school or daycare even when their eyes are dilated, it is recommended to inform teachers and caregivers that your child may have difficulty with near vision or want to stay inside for a few hours following the exam.