Mother and daughter talk with eye specialist when he look lens in child's eye with ophthalmoscope

25 percent of school-age children have vision problems, and only about one third of all American children have an eye exam before entering school, according to the American Optometric Association (AOA).

A child with uncorrected eye problems may have trouble seeing the board in class, seeing friends and family’s faces clearly, and participating in sports. Regular eye exams ensure that eye or vision problems are found and treated early.

“The human visual system goes through significant development after birth,” says Barry Kay, O.D. “The six muscles that control each eye have to learn to work together, move smoothly and accurately and turn in at the exact point to allow us to see up close. In addition the eyes have to learn to focus properly and see fine details.”

Dr. Kay says that the most of this development occurs before a child turns seven, so starting eye exams early is important.

If a child is squinting, holding things close to his or her face, or if a child’s eye is turning in or out independently of the other, Dr. Kay says that the child should have an eye exam. Ophthalmologists, pediatric ophthalmologists and optometrists can all perform eye exams.

Even if a child’s eyes and vision appear fine, parents should still make sure their eyes are examined regularly, as many eye and vision problems have no symptoms. Dr. Kay says, “Yearly exams can detect issues that could cause permanent vision loss and depth perception issues.” Children born prematurely or kids with a family history of eye problems may need more frequent and/or detailed eye exams.

When to schedule your child’s eye exams:

A child’s pediatrician or primary care provider usually performs initial eye screening exams, and he or she can let you know if your child needs an eye specialist.
According to the American Optometric Association (AOA), if the child has no symptoms and does not have any risk factors that increase his or her chance of developing eye problems, he or she should receive eye exams at the following intervals:

  • At 6 months
  • At 3 years
  • Before first grade and every two years after

If a child has risk factors that increase his or her chance of developing eye problems, he or she should receive eye exams at the following intervals:

  • By 6 months of age or as recommended
  • At 3 years of age or as recommended
  • Annually or as recommended

Children considered at risk of developing eye and vision problems include children:

  • Who are premature, have a low birth weight, have problems with oxygen at birth, or who have grade III or IV intraventricular hemorrhage
  • Have a family history of retinoblastoma, congenital cataracts, or metabolic or genetic disease
  • Whose mother has an infection during pregnancy, such as rubella, toxoplasmosis, STDs, cytomegalovirus or HIV/AIDS
  • Who have high refractive error
  • Who have strabismus
  • Who have anisometropia
  • Who are known or suspected to have central nervous system dysfunction such as developmental delay, cerebral palsy, dysmorphic features, seizures or hydrocephalus

During the eye exam:

  • Comprehensive eye exams performed by an eye specialist usually take half an hour to one hour, though they may take longer depending on your child’s needs. Many eye specialists perform eye exams in retail settings.
  • Medical history

During your child’s eye exam, an eye specialist will ask you questions about your child’s health history. He or she will want to know whether your child:

  • Was born prematurely
  • Blinks excessively
  • Has delayed motor development
  • Rubs his or her eyes frequently
  • Does not maintain eye contact
  • Cannot maintain a gaze while look at objects
  • Has poor eye tracking skills
  • Has failed a vision screening at school or during a doctor’s visit
  • Has a family history of eye or vision problems, including nearsightedness, farsightedness and lazy eye

If the child is old enough, the eye specialist will then measure the child’s “visual acuity” by having the child read letters on a chart distanced from where the child is sitting or standing. This test helps the eye specialist determine how clearly the eyes are seeing.

The eye specialist will also test a child’s depth perception, eye muscle movements, color vision and the way the child’s pupils respond to light.

For more information on when to get your child’s eyes checked, please visit