Raising Healthy Kids

Pediatric Eye Exam: Does Your Child Need One?

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By Henry Ford Health System Staff

When you hear about an eye exam for your child, you may be thinking: “Wait. Didn’t my kid already have one of these? Isn’t that what the nurse did at school?”

Not exactly. There’s a lot of confusion surrounding regular pediatric vision screenings and comprehensive pediatric eye exams, the two different types of vision tests that are administered to children.

Vision screenings vs. comprehensive pediatric eye exams 

A pediatric vision screening is a routine test performed in a pediatrician’s office or in schools by specially trained screeners. “This baseline test can help identify refractive errors such as nearsightedness and farsightedness,” says Kim H. Le, M.D., a pediatric ophthalmologist at Henry Ford Health System. “A pediatric eye exam is more in-depth.”

Pediatric ophthalmologists use an eye exam to help diagnose eye movement disorders, blocked tear ducts as well as conditions that could cause permanent vision loss if left untreated, such as amblyopia, pediatric cataracts and retinopathy of prematurity.

Pediatric vision screening schedule

The American Academy of Pediatrics and the American Academy of Ophthalmology recommend several routine vision screenings by age 5 to test whether your child’s vision is developing normally:

  • At birth: Performed in the newborn nursery, as part of the neonatal physical examination
  • 6 months: Performed during a routine evaluation in the pediatrician’s office
  • 3 ½ years: Also performed in the pediatrician’s office, this typically includes assessing visual acuity (sharpness of vision) on a picture type eye chart
  • 5 years: Performed either in the pediatrician’s office or at school

Past this, vision screenings are conducted at routine medical check-ups, during school checks or after the appearance of symptoms. The earlier pediatric eye conditions are uncovered, the better the outcome with treatment. If your child fails a pediatric vision screening, you should schedule a complete pediatric eye exam.

Other considerations for pediatric eye exams

In certain circumstances, your child may be referred for a pediatric eye exam, even if they pass a vision screening. These include:

  • Infants with specific symptoms: Poor tracking or visual behavior, an eye that seems to wander, cross or drift, or an abnormal white pupil
  • School performance issues: These can have several causes. However, a child with an undiagnosed visual problem may do poorly in school.
  • Children with learning disabilities: Reading and learning disabilities are not caused by abnormal vision, but an undiagnosed visual disorder can make a learning disability worse.

What happens during a pediatric eye exam?  

  1. Medical and family history: Certain medical conditions or a family history of some eye conditions may increase a child’s risk for developing eye problems.
  2. Basic eye exam: This exam checks visual acuity (sharpness), pupil function and eye muscle function.
  3. Dilation: This involves placing special drops in the child’s eyes to dilate their pupils. The drops take about 40 minutes to work.
  4. Eye structure and refractive exam: Once the eyes are dilated, the pediatric ophthalmologist examines the major structures, including the cornea, iris, lens, retina and optic nerve.
  5. Results: Your physician will discuss the findings, outline a treatment plan if needed, answer any questions and schedule any necessary follow-ups.

“No matter what age, we know this can be a stressful exam for children, who may not understand and may not be able to verbalize their symptoms or anxiety,” Dr. Le says. “Throughout the process, we work to put them at ease and make it fun.”

To schedule a pediatric eye exam, visit henryford.com or call 1-800-363-7575.

Kim H. Le is a pediatric ophthalmologist who sees patients at Henry Ford OptimEyes Super Vision Centers in West Bloomfield and Dearborn.

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