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Home » Eye Care Services » Comprehensive Eye Exams » Children’s Eye Care

Children’s Eye Care

According to experts, 80% of learning is visual, which means that if your child is having difficulty seeing clearly, his or her learning can be affected. This also goes for infants who develop and learn about the world around them through their sense of sight. To ensure that your children have the visual resources they need to grow and develop normally, their eyes and vision should be checked by an eye doctor at certain stages of their development.

According to the American Optometric Association (AOA) children should have their eyes examined by an eye doctor at 6 months, 3 years, at the start of school, and then at least every 2 years following. If there are any signs that there may be a vision problem or if the child has certain risk factors (such as developmental delays, premature birth, crossed or lazy eyes, family history or previous injuries) more frequent exams are recommended. A child that wears eyeglasses or contact lenses should have his or her eyes examined yearly. Children’s eyes can change rapidly as they grow.

Eye Exams in Infants: Birth – 24 Months

A baby’s visual system develops gradually over the first few months of life. They have to learn to focus and move their eyes, and use them together as a team. The brain also needs to learn how to process the visual information from the eyes to understand and interact with the world. With the development of eyesight, comes also the foundation for motor development such as crawling, walking and hand-eye coordination.

You can ensure that your baby is reaching milestones by keeping an eye on what is happening with your infant’s development and by ensuring that you schedule a comprehensive infant eye exam at 6 months. At this exam, the eye doctor will check that the child is seeing properly and developing on track and look for conditions that could impair eye health or vision (such as strabismus(misalignment or crossing of the eyes), farsightedness, nearsightedness, or astigmatism).

Since there is a higher risk of eye and vision problems if your infant was born premature or is showing signs of developmental delay, your eye doctor may require more frequent visits to keep watch on his or her progress.

Q&A About Childrens' Eye Exams
Why is it important for children to have their eyes examined?

 It is essential that children have annual eye exams starting at 6 months of age. Healthy vision is essential to a child’s ability to learn and achieve their academic potential, as well as to play sports and other activities.

At what age should a child have his or her first eye doctor’s appointment?

 It is important to ensure that children be seen at about 6 months of age. This is when it is critical to ensure that the eyes are developing normally.

How often do you recommend children come in for a routine eye exam?

 I always recommend yearly eye exams for all children. As they go through growth spurts, their vision can also go through changes.

Are there any signs that a child should have his or her eyes checked?

For infants, always look for an eye turn or look for things like the inability to pick up objects like cheerios or small snacks. In preschool age children look for them to see if they are sitting really close to the tv and not wanting to sit back at all from the tv.

Describe something – technique or technology – that makes a pediatric eye exam or pediatric eye care different from adult eye care.

Binocular vision and conditions like strabismus (lazy eye) are much more important to uncover at an earlier age. If found soon enough, vision therapy can greatly help improve a child's vision, and in some cases give them better vision as they grow older if left untreated or undiagnosed.

What can a child/parent expect during a pediatric eye exam?

We will do a variety of different tests.

It takes some time for a baby's vision skills to develop. To assess whether your infant's eyes are developing normally, your eye doctor may use one or more of the following tests:

  • Tests of pupil responses evaluate whether the eye's pupil opens and closes properly in the presence or absence of light. 
  • "Fixate and follow" testing determines whether your baby can fixate on an object (such as a light) and follow it as it moves. Infants should be able to perform this task quite well by the time they are 3 months old. 
  • Preferential looking involves using cards that are blank on one side with stripes on the other side to attract the gaze of an infant to the stripes. In this way, vision capabilities can be assessed.
What do you look for in during a pediatric eye exam?

 Besides looking for nearsightedness, farsightedness, and astigmatism (refractive errors), your eye doctor will be examining your child's eyes for signs of these eye and vision problems commonly found in young children:

  • Amblyopia. Also commonly called "lazy eye," this is decreased vision in one or both eyes despite the absence of any eye health problem or damage. Common causes of amblyopia include strabismus (see below) and a significant difference in the refractive errors of the two eyes. Treatment of amblyopia may include patching the dominant eye to strengthen the weaker eye.
  • Strabismus. This misalignment of the eyes, often caused by a congenital defect in the positioning or strength of muscles that are attached to the eye and which control eye positioning and movement. Left untreated, strabismus can cause amblyopia in the misaligned eye. Depending on its cause and severity, surgery may be required to treat strabismus.
  • Convergence Insufficiency. This is the inability to keep the eye comfortably aligned for reading and other near tasks. Convergence insufficiency can often be successfully treated with vision therapy, a specific program of eye exercises.
  • Focusing problems. Children with focusing problems (also called accommodation problems) may have trouble changing focus from distance to near and back again (accommodative infacility) or have problems maintaining adequate focus for reading (accommodative insufficiency). These problems often can be successfully treated with vision therapy.
  • Eye teaming problems. Many eye teaming (binocularity) problems are more subtle than strabismus. Deficiencies in eye teaming skills can cause problems with depth perception and coordination.
In addition to a routine eye exam, what other services do parents bring their children to your office for?

At Spartan Eyecare, we are a Primary Eye Care facility. We handle all types of eye infections, foreign body removals, glaucoma diagnosis and treatment, cataracts, macular degeneration and specialize in Diabetic Retinal Exams.

What is your busiest time of year for eye exams for kids?

 Back to school season usually starts for us in August, which tends to be our busiest time of year for kids exams.

Can you share a story that was particularly successful or inspirational about pediatric eye care at your office?

 We had a 7-year-old boy who was falling behind in his learning. The boy was diagnosed with Attention Deficit Disorder. His teacher told his parents he had a hard time reading and was skipping lines. They recommended that they see an eye doctor. He was fitted with a pair of new glasses, with a moderately high prescription. 2 years later, they returned to our office and the child was performing at an exceedingly high level for his age.

Eye Exams in Preschool Children: 2-5

The toddler and preschool age is a period where children experience drastic growth in intellectual and motor skills.  During this time they will develop the fine motor skills, hand-eye coordination and perceptual abilities that will prepare them to read and write, play sports and participate in creative activities such as drawing, sculpting or building.  This is all dependent upon good vision and visual processes.

This is the age when parents should be on the lookout for signs of lazy eye (amblyopia) - when one eye doesn’t see clearly, or crossed eyes (strabismus) - when one or both eyes turns inward or outward. The earlier these conditions are treated, the higher the success rate.

Parents should also be aware of any developmental delays having to do with object, number or letter recognition, color recognition or coordination, as the root of such problems can often be visual.  If you notice your child squinting, rubbing his eyes frequently, sitting very close to the tv or reading material, or generally avoiding activities such as puzzles or coloring, it is worth a trip to the eye doctor.

Eye Exams in School-Aged Children: Ages 6-18

Undetected or uncorrected vision problems can cause children and teens to suffer academically, socially, athletically and personally.  If your child is having trouble in school or afterschool activities there could be an underlying vision problem. Proper learning, motor development, reading, and many other skills are dependent upon not only good vision, but also the ability of your eyes to work together. Children that have problems with focusing, reading, teaming their eyes or hand-eye coordination will often experience frustration, and may exhibit behavioral problems as well. Often they don’t know that the vision they are experiencing is abnormal, so they aren’t able to express that they need help.

In addition to the symptoms written above, signs of vision problems in older children include:

  • Short attention span
  • Headaches
  • Frequent blinking
  • Avoiding reading
  • Tilting the head to one side
  • Losing their place often while reading
  • Double vision
  • Poor reading comprehension

The Eye Exam

In addition to basic visual acuity (distance and near vision) an eye exam may assess the following visual skills that are required for learning and mobility:

  • Binocular vision: how the eyes work together as a team
  • Focusing
  • Peripheral Vision
  • Color Vision
  • Hand-eye Coordination
  • Tracking

The doctor will also examine the area around the eye and inside the eye to check for any eye diseases or health conditions. You should tell the doctor any relevant personal history of your child such as a premature birth, developmental delays, family history of eye problems, eye injuries or medications the child is taking. This would also be the time to address any concerns or issues your child has that might indicate a vision problem.

If the eye doctor does determine that your child has a vision problem, they may discuss a number of therapeutic options such as eyeglasses or contact lenses, an eye patch, vision therapy or Ortho-k, depending on the condition and the doctor’s specialty.   Since some conditions are much easier to treat when they are caught early while the eyes are still developing, it is important to diagnose any eye and vision issues as early as possible.

Following the guidelines for children’s eye exams and staying alert to any signs of vision problems can help your child to reach his or her potential.