When should my child have their first eye exam?
Your child should have their first eye exam at 6-12 months of age, even if they are not having any symptoms. This exam ensures that their vision is able to develop normally. Vision does not just happen. A child's brain learns how to use eyes to see. If their vision is not clear for whatever reason, vision will not develop fully. The early a vision deficit is caught, the better the visual outcomes will be. Children should be seen annually for an eye exam. If your child is diagnosed with a vision problem or eye condition, such as amblyopia (lazy eye), they will likely need to be followed more frequently.
My child has had a vision screening at school and/or at the pediatrician and everything was fine, do they need to have an eye exam?
An exam at the pediatrician’s office and nurse’s office at school are not replacements for comprehensive exams with an eye care professional. The main test at these exams is visual acuity which is not a good measure of everything that is happening in the eye. They are not checking for eye health or how the eyes are working together. It also does not mean your child does not need glasses, since they do not check their prescription at these exams. At a comprehensive eye exam, we use techniques and technology to check their visual acuity, prescription, binocularity, and eye health.
How should I prepare my child for their first eye exam?
For young children, an eye exam can cause anxiety, especially if it is their first visit to an optometrist or they are visiting a new clinic. Keep in mind that testing will be age appropriate and easy to answer, whether they include shapes, pictures or letters. If your child has previously worn glasses, even if they do not currently wear them, please bring them with you. It is also very helpful for our doctors if you have a list of their medications and their medical history with you.
For infants and toddlers, we recommend bringing them after nap time and feeding. This way our doctors will have the best chance at getting the most information about their eyes. Please do not schedule them during a scheduled nap time or right before they usually have a meal.
For some children, they do best when they are prepared for what will happen:
Tests are generally pain-free and quiet. There will be shining lights but no shots.
There are no right and wrong answers to questions asked
The doctor will most likely put eye drops in, which may sting but for just a moment.
Hyperopia (also known as farsightedness) - means that the eye is too weak in power. An internal structure in the eye which increases power can overcome this. Low amounts of hyperopia are normal in infants and children, but high amounts will prevent visual development. This condition is corrected with glasses and needs to be monitored annually for changes.
Myopia (also known as nearsightedness) - means that the eye is too strong in power. This cannot be overcome because there is no structure in the eye that can decrease the power of the eye. Even low amounts will cause blurry vision. This condition is treated with glasses and needs to be monitored annually or semi-annually for progression.
Astigmatism - means that the shape of the eye differs vertically versus horizontally. In other words, it means that the eye is not perfectly spherical. This is a common state for the eyes to be in and is not a disease process. Symptoms include letters appearing stretched, glare, and visual distortions. This requires different prescriptions horizontally and vertically, which can be corrected with glasses.
Amblyopia - also known as a lazy eye. This condition means that the eye cannot see 20/20 even with the help of glasses due to the incomplete visual development. This can occur in one of both eyes. This condition is usually caused by a high prescription that is not caught early enough. If a child’s vision is very blurred, visual development will not be completed. Treatment for this condition includes full-time wear of glasses and patching in moderate to severe cases. Outcomes are better when detected earlier.
Allergic conjunctivitis - this is a red eye caused by allergies. Allergy in children is common and treated with drops.
Dry Eyes - this condition is becoming more common since children now spend more time on digital devices. Treatment includes limiting digital device usage and lubricating eye drops.
1. What is dilation and why is it important?
Dilation is when medical eye drops are placed in the eye by our doctors. These drops open up the pupil making so we can thoroughly assess the health or the back of the eye. The drops also help relax the focusing system in the eye revealing a person’s true prescription. At their first eye exam, the standard of care is that all patients are dilated. This allows our doctors to properly assess the health of the back of the eye to rule out ocular diseases. Most children have a strong focusing system, so the drops also allows us to get a reading of their true prescription that could be hiding due to their focusing system being involved. Drops are safe for infants and children.
Glasses are prescribed when the eyes are too strong or too weak to see well. This allows for normal development of their eyes and will help them with learning in the classroom. When they are not wearing glasses it’s similar to having to carry a weight all day, even if they are able to do it successfully, overtime it will cause strain and complications. Glasses will decrease their visual workload, so your child will be able to focus on succeeding in school, sports, and social activities.
Part-time wear is usually recommended when your child has a low prescription. They can use help in the classroom setting. Their visual system benefits from having glasses, but their vision is acceptable without glasses, so they do not have to wear them when playing outdoors or with certain activities.
Full-time wear is recommended when your child’s vision needs glasses to have usable vision in one or both eyes. Glasses are necessary for them for all activities in and outside the classroom. In many cases, wearing glasses is necessary for visual development. If our optometrist recommends glasses full time, the patient should be wearing them for all waking activities except for showering.
Contact lenses are approved for all ages. For some children, contact lenses are medically necessary due to high prescriptions or vision imbalances that are more effectively treated with contacts. For normal soft lenses, we recommend any age that your child is mature enough to understand the importance of hygiene and responsibility. For some children that may be age 7, for others it may be in their teenage years. For children and teens, daily disposable contact lenses are always recommended in order to reduce the risk of infections and complications.
Our optometrists recommended taking breaks with near work. For every 20 minutes your child is reading or on a device, we recommend taking a 20 second break to look at something far away. Studies have shown a correlation between long periods of near work and development of nearsightedness. Spending more time outdoors has been shown to be protective against the development of nearsightedness. We also advise reducing screen time on devices if possible. The World Health Organization recommends limiting or eliminating screen time for all children under 5 years old. For children under 1 years old, no screen time is recommended. For children from 2-5, 1 hour or less of high quality screen time is recommended.
No, studies show that wearing glasses will not make your child’s eyes worse. The eye is changing and growing as your child grows, this occurs in all children. When this happens, their prescription may change. This may cause their prescription to increase or decrease. This process occurs whether or not your child wears glasses. In fact, studies show that undercorrection (your child not wearing glasses), actually causes their prescription to get worse at a faster rate.
As your child grows we expect that their eyes will also be growing. As their eyes grow, their prescription has the potential to change. For nearsighted (myopic) children, any change in their prescription can be alarming since each step increases their risk for complications in the future. Our optometrists recommend myopia control treatments to help slow down their prescription if any change is seen. Treatment becomes more alarming and necessary if the prescription is changing by more than -0.50D.
Another aspect of the visual system that is checked at every pediatric eye examination is your child’s ability to use both eyes together. Normal binocular vision means that both eyes are being used simultaneously, equally and accurately as a coordinated team. If binocular vision is not occurring, your child may experience symptoms such as eye strain, headaches, and/or double vision. Symptoms can start at any age. Some diagnoses include:
1. Convergence insufficiency - the inability to effectively focus on a near target due to the deficiency in being able to bring the eyes inwards
2. Accommodative dysfunction - the focusing system in the eye is not able to effectively increase power to focus on a near target
3. Strabismus - one of the eye muscles is underacting, causing the eye to be turned, either constantly or intermittently. The most common strabismus is when the one or both eyes intermittently turns outwards.
Office Hours
Mon-Wednesday : 9:00 am - 5:45 pm
Thursday: 8:45 am-4:45 pm
Friday: 8:45 am- 4:45 pm
Closed : Saturday, Sunday
