Vision and health problems can impact kids’ futures. That’s why Dr. Steven Bennett of Bennett Optometry in Ann Arbor urges regular eye exams. “A lot of parents believe that their children get an eye exam at the pediatrician’s or at school. When they stand 10 feet away from a chart and read letters, that is not an eye exam,” says Bennett.
Primary care pediatricians perform basic tests that can detect problems, but they’re not as thorough as the eye doctor. Here’s a guide to key ages.
The early years
The first eye exam is at birth. Obstetricians check for signs of infection and abnormalities – and any milky white look to the pupil indicating cataracts.
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Most kids start to fix focus on objects and follow objects with their eyes at 4 to 8 weeks. If an infant’s eyes don’t appear to follow toys or faces, contact an eye doctor.
If everything appears normal, the first eye exam should be at 6 months. Doctors watch how baby responds to noises, lights and toys to see if eyes are working properly. They also check eye alignment, how eyes are moving together, and shine a light on the child’s eyes to check pupil reflex.
Infants’ eyes may have to be dilated so the doctor can check the health and function of the retina. If you notice baby’s eyes turning in or out, contact your ophthalmologist. It could indicate strabismus, a muscle imbalance; early detection is essential for successful treatment.
Once kids are 3 to 5, it’s possible to get a better idea of their visual acuity, or ability to see. They can now identify numbers, letters and pictures, and doctors can perform tests, such as the “tumbling E,” where the child tells the doctor what direction a series of Es are pointing.
Children also try identify pictures from varying distances, which indicates how well they see items close up or far away.
Dr. John Roarty, chief of ophthalmology at Children’s Hospital of Michigan in Detroit, says kids at this age need to be checked by an optometrist or ophthalmologist if they fail vision primary screenings, if parents notice a problem, or if there’s a strong family history of eye problems.
Ditto for any eye irregularities. If kids can’t see or complain of seeing flashing lights, “spiderwebs” or “floaters,” they need to have their eyes checked immediately. Kids who are poked or hit in the eye by an object need to be checked for a corneal abrasion, retinal detachment or other serious injuries. Red or discharging eyes also should be checked for infections.
In grade school, vision problems can become more apparent. Squinting to see the chalkboard, holding books close to the face, headaches and bad grades can all be signs.
“All of us are born farsighted,” Bennett explains. “As we develop, depending on our genetics, we lose that and can become either nearsighted or farsighted.” Farsighted kids can have difficulty seeing items close up; for nearsighted kids, the issue is items that are far away.
Once a vision problem is detected, kids need to see an eye doctor annually. Vision can change dramatically because eyes are still developing.
Also at this age, get kids checked for eye impairments and diseases. “The visual system tends to lock in around 7 to 10 years of age. If you don’t catch it until they’re 12 to 14, it’s too late to treat the problem,” Roarty says.
Teens and beyond
As children grow older, they also can become more active, which increases their risk for eye injuries.
Sports related injuries are common – especially in paintball, racquetball and baseball. Encourage protective glasses. Teens should wear quality safety goggles when using power tools, and take care with sharp objects and anything that could harm their eyes.
Once teens are driving, clear vision becomes a matter of safety, too. Teens with vision problems still need annual exams to aid driving as well as academic success.
As teens become adults, it’s important they take responsibility for eye care. Vision screenings and examinations for disease help ensure general health, too. Signs of diabetes, multiple sclerosis, brain tumors and more are often detected with an eye exam.
This post was originally published in 2010 and had been updated for 2017