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  • Writer's pictureMaria Cholakova

Vision Screening for Children: How Often to Take Your Kids to an Eye Doctor?

Updated: Apr 10, 2023

Good vision is crucial for a child's development, learning, and overall well-being. For that reason, protecting a child's eyesight should be a priority. Vision screening and eye exam checkups can identify any vision problems early on. As well as prevent any long-term consequences from them. But how often should you take your kids to an eye doctor?


In this article, we will discuss the importance of vision screening for children and provide an eye exam checkup schedule. Everything we share here is based on recommendations from the ophthalmology specialist Atanas Bogoev M.D., and the guidelines from AAPOS.


Table of Content:

3.1. Newborn


Why is Vision Screening important for children?


According to the American Association for Pediatric Ophthalmology and Strabismus (AAPOS), approximately one in every 20 preschool children has a vision problem, and one in four school-aged children has some form of vision impairment.


Vision problems in children can affect their learning and academic performance, social interactions, and even their safety. For example, children with poor vision may have difficulty reading, focusing, and following instructions, leading to academic struggles. In addition, children with untreated vision conditions may have trouble playing sports or participating in other physical activities, which can affect their self-esteem and overall well-being.


Early detection and treatment of vision problems in children are crucial because the visual system in the brain is still developing during the first few years of life. If vision problems go undetected and untreated, they can lead to permanent vision loss or even blindness. For this reason, we urge that all children undergo regular vision screenings and eye exam checkups with ophthalmology specialists.


Kid playing with a loop

What is Vision Screening?


Vision screening is a quick and straightforward procedure that checks a child's visual acuity, or the ability to see clearly at a distance and up close. The screening is typically performed by a medical professional using an eye chart or other vision screening tools. And while vision screening is not a substitute for a comprehensive eye exam, it is rather a first step in identifying children who may need further evaluation.


The eye care professionals who can perform vision screening for children are:

  • Pediatricians

  • Family physicians (GP)

  • Optometrists

  • Ophthalmologists

Difference between a comprehensive eye exam and vision screening


Vision screening is an eye checkup that helps to confirm visual acuity and detect early symptoms of eye problems in infants and youngsters. While a comprehensive eye exam helps diagnose eye conditions and diseases, and in-depth assess their severity.


Moreover, preventive vision screenings are typically conducted by the child's pediatrician or the family physician. While comprehensive exams are always carried out by ophthalmologists.


Eye Exam Checkup Schedule for Children (Vision Screenings Timeline)


Now that we have established the need for regular vision screening at a young age, it is time to define what regular means and how often to take your child to the eye doctor.


The American Association for Pediatric Ophthalmology and Strabismus (AAPOS) and the American Academy of Ophthalmology (AAO) advise that all newborns should be screened for eye problems in the nursery or in the pediatrician's office. They also recommend that children undergo eye exams for visual acuity, eye alignment, and eye movement at the following ages:

  • 6 months

  • 3 years

  • 5 years

Repeat screening every 1-2 years after age 5, or according to your ophthalmologist's recommendation.


vision screening vs comprehensive eye exam

Some factors that may warrant more frequent vision screenings or eye exams include a family history of eye problems, premature birth, or low birth weight. As well as any signs of vision problems, such as squinting, rubbing their eyes, or holding objects too close to their face.


If during the vision screening the eye doctor detects any problems, they can refer the child to an ophthalmology specialist for a thorough eye examination.


Newborn


> During the vision screening, the pediatrician or healthcare personnel checks:

  • History of ocular disease

  • Vision assessment

  • Assessment of ocular motility

  • Lids examination

  • Pupil examination

  • Red reflex examination

> When to refer the child to an ophthalmologist:


When a newborn is premature, exhibits visible signs of eye disease, or has a childhood eye disease in the family, you need to consult an ophthalmologist for the next steps in screening and treatment.


6 months to 1 year old


> During the vision screening, the pediatrician or healthcare personnel checks:

  • History of ocular disease

  • Vision assessment

  • Assessment of ocular motility

  • Lids examination

  • Pupil examination

  • Red reflex examination

  • Visually inspect the eyes

  • Examine eye alignment and movement

> When to refer the child to an ophthalmologist:


Babies with poor tracking, red reflex abnormalities, gray or white pupil, or retinoblastoma history in the family are sent for vision screening and consultation with an ophthalmology specialist.


1 year to 3 years old


> During the vision screening, the pediatrician or healthcare personnel checks:

  • History of ocular disease

  • Vision assessment

  • Assessment of ocular motility

  • Lids examination

  • Pupil examination

  • Red reflex examination

  • Visual acuity test

  • Ophthalmoscopy

  • Photoscreening

> When to refer the child to an ophthalmologist:


The pediatrician or examiner should refer children with strabismus, chronic tearing or discharge, and children who fail photoscreening to an eye specialist who can suggest treatment options.


3 years to 5 years old


> During the vision screening, the pediatrician or healthcare personnel checks:

  • History of ocular disease

  • Vision assessment

  • Assessment of ocular motility

  • Lids examination

  • Pupil examination

  • Red reflex examination

  • Visual acuity test or Photoscreening

  • Ophthalmoscopy

> When to refer the child to an ophthalmologist:


Vision screening medical personnel should refer the child to an ophthalmologist if the child has strabismus, lazy eye, refractive errors (myopia, hyperopia, astigmatism), or focusing problems.


5 years old and older


> During the vision screening, the pediatrician or healthcare personnel checks:

  • History of ocular disease

  • Vision assessment

  • Assessment of ocular motility

  • Lids examination

  • Pupil examination

  • Red reflex examination

  • Visual acuity test

  • Ophthalmoscopy

> When to refer the child to an ophthalmologist:


The referral criteria for this age group include first signs of myopia, hyperopia, or astigmatism, as well as focusing problems, and reading difficulties. An ophthalmologist can administer proper treatment.


When is the right time to schedule a comprehensive eye exam?

Regular vision screenings conducted by pediatricians are extremely beneficial to your child's eye health. However, there are some signs that you might need to take your child to see an ophthalmology specialist for a comprehensive eye exam:

  • Your child fails a vision screening

  • Vision screening results are inconclusive

  • The physician cannot conduct the vision screening

  • Your child has a complaint about their vision

  • The physician or school nurse refers your child to see an eye doctor

  • You notice myopia, hyperopia, or astigmatism symptoms like eye squinting, blurry vision, eye strain, or eye fatigue

  • You notice symptoms of a learning disability, developmental delay, neuropsychological disorder, or behavioral challenges

  • Your child is at risk for developing eye problems

The risk of developing eye problems is higher in children with chronic, congenial, or inherent medical conditions and those with a family history of amblyopia, strabismus, retinoblastoma, congenital cataracts, or glaucoma.


Child vision screening and eye exam

Vision screening is a critical component of a child's overall healthcare because it serves to identify any vision problems early on, preventing long-term consequences. Regular vision screenings and comprehensive eye exams are essential to ensure that children have the best possible visual development.


Parents and caregivers should follow the recommendations regarding the eye exam checkup schedule for children and consult their healthcare provider if they have any concerns about their child's vision. With early detection and treatment, most vision problems in children are reversible or manageable, allowing them to see the world clearly and thrive.


Learn more about your child's eye health in the Ophthalmology24 blog for patients.


Resources:

All medical facts and statements are checked by Atanas Bogoev M.D.


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