What Is a Pediatric Eye Exam?

While you may be used to scheduling eye care visits for yourself, you may be less certain of what to expect from a pediatric eye exam for your child. You may even find yourself wondering if vision screenings are necessary at a young age. The answer is a definite yes.

It's important for your child’s eyes to be evaluated, even if they are still an infant. Here's an overview of when your child needs an eye exam and what to expect at an appointment.

Infant child during pediatric eye exam with expert eye doctor

Pediatric Eye Exams Vs. Vision Screenings

Young children often receive vision screenings instead of comprehensive eye exams. These are less in-depth than a full-fledged pediatric eye exam and help to determine whether further eye testing is needed by an eye doctor.

The pediatric ophthalmologists from The American Academy of Ophthalmology recommends getting your child’s vision tested:

  • At birth and again between six and 12 months of age

  • Between the ages of three and five

  • When first entering school, and then every year or two

A vision screening is usually not a replacement for a comprehensive eye exam. In fact, as many as 60% of children with vision issues slip through the screening cracks.

Even if the screening goes well, it can still be important to schedule a pediatric eye exam, especially if you've noticed symptoms like frequent squinting or trouble focusing, if your child has a developmental disorder, or if you have a family history of eye disease. Even without these symptoms, the American Optometric Association recommends scheduling your child's first full, in-person exam between the ages of three and five.

Kids Eye Exam Location

What to Expect at a Pediatric Eye Exam

What happens at a pediatric eye exam varies depending on your child's age.

Eye Examination For Infants

An exam for infants will not be as regimented as when you have your own eyes examined. In this case, the exam will include using lights and toys to engage the baby and make sure that vision is developing as expected. At this stage the eye doctor will also check for the following:

  • Proper eye movement

  • Signs of developing nearsightedness (trouble seeing well at distance) or farsightedness (trouble seeing well at close range)

  • Signs of the cornea (the clear dome at the front of the eye) developing an irregular shape

  • Ability to focus at different distances

  • Problems at the back of the eye by testing your child's red reflex. This reflex occurs when light passes through the pupil and is reflected off the back of the eye; it's what causes "red eyes" in pictures taken with a flash.

Eye Examination for Young Children (Ages 3-5)

Those in the preschool age group (ages three to five) can participate more in the eye examination even though they likely can't yet read. Instead of the normal chart with letters, the eye doctor will likely use what's known as a tumbling E chart. With this eye chart, your child will be asked to extend their fingers in the same direction that the E is facing. You may even want to try practicing this with your child ahead of time to help them get the hang of it. For young children with stronger vocabularies, the eye doctor may use a chart with symbols such as a house, a square, a circle, or an apple in place of the tumbling E chart. In addition, the eye doctor will likely test for things like:

  • Color vision

  • Depth perception

  • Crossed eyes

  • A lazy eye, in which one eye is weaker than the other and thus doesn't focus or develop as well. This can be successfully treated, especially when caught early.

Kids Eye Exam

Pediatric Eye Exams are Important

Pediatric eye exams are important for evaluating whether your child needs glasses or if they have any eye health issues that need addressing. If the eye eye doctor thinks additional visits are needed, they will let you know and explain any next steps. In many cases, however, you'll simply schedule the next eye examination check-up. Hopefully, this will put your child on good footing for a lifetime of productive eye visits and good eye health.