When is a child’s first eye exam?
The question always arises when I am introduced as an Optometrist who deals with children and their visual needs. “When should I bring my child in for a first eye exam?”. The answer to this common question is usually met with surprise and doubt. “But isn’t that too young?”
The Ontario Association of Optometrists (OAO) recommends that all children have a comprehensive first eye exam at 6 months of age. The next exam is at the age of 3 years with yearly follow-ups as recommended by an eye care professional1. The OAO, Optometrists and other healthcare professionals realize that 80% of learning begins through the eyes2.
Reasons for a child’s first eye exam
The development of the visual system and sight starts at an early age. As a result, any interference to this visual development can have permanent consequences on the eye to reach its full visual potential. Some commonly encountered oculo-visual problems found by Optometrists in infants and young children are, strabismus (a misalignment of the eyes) and anisometropia (an unequal refractive error between the eyes). Both of these conditions can hinder the development of sight in the affected eye. If either of these conditions are diagnosed early the child’s eyesight can be rehabilitated. A family history of high refractive errors, strabismus, premature birth and/or low birth weight, maternal infections at birth as well as substance abuse during pregnancy are common risk factors placing an infant at jeopardy.
What can be done for a child’s first eye exam?
Eye care professionals do not require that an infant or a child have the ability to speak/communicate or have knowledge of the alphabet in order to perform an assessment. Vision can be tested by referring to pictures, numbers or symbols. Eye tracking and the steadiness of the gaze can indicate visual problems in young infants. Muscle balance testing and ocular motility can be easily assessed. Determining the refractive state (the prescription) of an infant or child’s vision can be done objectively (without responses) by the use of a technique called retinoscopy. All children’s examinations are typically done after instilling a cycloplegic eyedrop into the child’s eyes. This also allows for a dilation of the child’s pupil for a view into the eyes to ensure that the ocular media are clear and free from any disease process.
For further information please refer to the OAO website: www.optom.on.ca.
Dr. David Lawrence of Van Ymeren, Townshend, Lawrence, Moore and Associates Optometrists
I would like to thank to OAO for the use of their website and their assistance in the writing this article.