"My child seems like they can see fine"
"The pediatrician didn’t specifically recommend an eye exam after doing that test"
"Does my child actually need an eye exam?"
These are common thoughts parents have regarding their child’s eyes and vision.
As an optometrist, these are the answers to the most common frequently asked questions I get from parents about their children’s eyes:
What does a pediatrician check?
Pediatricians use an autorefractor that roughly estimates a child’s glasses prescription. If the autorefractor number is high, the pediatrician may recommend a comprehensive eye exam by an optometrist or ophthalmologist.
Pediatricians do not conduct eye exams, but rather they conduct a brief vision screening to catch some children who need glasses. This vision screening is not comprehensive — it does not examine eye alignment, eye health, depth perception, color vision, or definitively determine if glasses are needed.
Why is an eye exam important?
Eye exams by an optometrist or ophthalmologist thoroughly examine the overall health of the eyes, eye alignment, eye movements, depth perception, color vision, focusing ability, eye teaming skills (binocularity), peripheral awareness, distance vision, near vision, and if a glasses prescription is beneficial. These comprehensive exams identify more eye and vision concerns than a basic vision screening conducted by a pediatrician.
When should my child have an eye exam?
Children should have their first comprehensive eye examination around 6-12 months of age, another examination at age 3-5, and again before starting school . Once starting school, a yearly eye exam is recommended as prescriptions can change quickly, similar to clothing and shoe sizes.
It is important to remember that vision screenings conducted at school by a nurse are not a substitute for an eye examination conducted by an optometrist or ophthalmologist. School vision screenings, conducted by nurses, are very important and do catch some vision problems, but unfortunately they cannot detect all eye and vision problems.
If you have a specific visual concern for your child, consider finding an optometrist or ophthalmologist specifically trained in pediatrics. If you suspect poor vision or a lazy eye, schedule an eye examination at your earliest convienence. If family members have a history of eye or vision problems, schedule more frequent eye examinations based on the recommendation of your eye doctor.
What if my child has never complained of blurry vision and seems to see “fine”?
Children almost never complain of blurry vision. Blurry vision may be their “normal” and they do not realize their vision can be far clearer. Blurry vision of one or both eyes impairs a child’s ability to learn in school. Oftentimes parents believe their child’s vision is fine because their child can see objects far away and read well, but they may not realize that only one eye may actually be seeing clearly.
Why do kids need to see well?
This may seem like a silly question, but parents sometimes do not realize how crucial vision is to early child development. Learning in school is primarily driven by vision. Children with uncorrected vision may have a more difficult time developing cognitive skills and social skills.
Likewise, poor vision hinders fine and gross motor development. If vision is only clear in one eye, the child may struggle to develop normal depth perception, spatial awareness, hand-eye coordination, and reading skills. Vision problems may also limit career choices — for example, a child who is color blind will may not be able to grow up to be a pilot, firefighter, or police officer .
Knowing the state of your child’s eyes is always beneficial. Helping a child have the best possible vision puts them in the best position to learn and develop life skills.
What if I don’t have vision insurance?
Talk to your medical insurance provider. Oftentimes annual eye examinations may be covered by medical insurance, especially if your child has a specific eye diagnosis. An infant eye exam is so essential that optometrists created a public health program called InfantSEE which offers free eye examinations to infants between 6 and 12 months of age .
Written by Kaleb Abbott, O.D., M.S.
 Recommended Eye Examination Frequency for Pediatric Patients and Adults; https://www.aoa.org/patients-and-public/caring-for-your-vision/comprehensive-eye-and-vision-examination/recommended-examination-frequency-for-pediatric-patients-and-adults
 When Colorblindness Cramps Careers; https://www.nytimes.com/2001/05/23/jobs/when-colorblindness-cramps-careers.html