Eye Testing for Preschool Children
Some parents are surprised to learn that preschool-age children do not need to know their letters in order to undergo certain eye tests, even when they are too young or too shy to verbalize. Trained vision screeners may be able to detect certain eye problems in preschoolers. (Image: VIP Study Center, The Ohio State University College of Optometry)

Some common eye tests used specifically for young children include:
 

• LEA Symbols for young children are similar to regular eye tests using charts with letters, except that special symbols in these tests include an apple, house, square and circle.
• Retinoscopy is a test that involves shininga light into the eye to observe the reflection from the back of the eye (retina). This test helps eye doctors determine your child's eyeglass prescription.
• Random Dot Stereopsis testing uses special patterns of dots and 3-D glasses to measure how well your child's eyes work together as a team.

In addition to nearsightedness, farsightedness and astigmatism, common vision problems of schoolchildren include:
 

• Lazy eye (amblyopia): Your eye doctor will want to rule out amblyopia, or "lazy eye," which is decreased vision in one or both eyes without detectable anatomic damage. Unfortunately, amblyopia is not always correctable with eyeglasses or contact lenses and may require eye patching to strengthen the weaker eye. Your child's eyes should be examined early for vision problems such as "lazy eye" (amblyopia), in which one eye usually is weaker than the other. With amblyopia, eye patching often is used to help strengthen the weaker eye. (Image: Eye-Lids Custom-Made Patches)
• Misalignment of eyes (strabismus): Crossed or misaligned eyes (strabismus) can have different causes, such as problems with muscle control in the affected eye or eyes. Strabismus is a common cause of amblyopia and should be treated early in childhood so vision and eye teaming skills can develop normally.
• Inability to maintain eye alignment when viewing near objects (convergence insufficiency): Eye doctors will assess the ability of eyes to pull inward (convergence) and maintain proper alignment for comfortable reading.
• Focusing ability, depth perception, and color vision: The eye doctor also may test your child's focusing (accommodation) ability. Depth perception or ability to gauge distances between objects also may be examined, and color blind tests may be used to assess your child's color vision. [Read more about color vision and how the eye refracts light.]
• Anterior eye and eyelid health: Your eye doctor will closely examine your child's eyelids to look for abnormal or infected eyelash follicles, bumps, eye discharge, and swelling (edema). The doctor also will examine the cornea, iris, and lens to look for cloudiness (opacities) or other irregularities.

Vision Screening and Your Child's Performance in School
Remember that appropriate vision testing at an early age is vital to ensure your child has the visual skills he or she needs to perform well in school.

A child who is unable to see print or view a blackboard can become easily frustrated, leading to poor academic performance. Some vision problems, such as lazy eye, are best treated if they are detected and corrected as early as possible while the child's vision system is still developing.

As a parent, you may wonder whether your preschooler has a vision problem or when you should schedule your child's first eye exam.

Eye exams for children are extremely important because 5 to 10 percent of preschoolers and 25 percent of school-aged children have vision problems.* Early identification of a child's vision problem can be crucial because children often are more responsive to treatment when problems are diagnosed early.

According to the American Optometric Association (AOA), infants should have their first comprehensive eye exam at 6 months of age. Children then should have additional eye exams at age 3, and just before they enter the first grade — at about age 5 or 6.

For school-aged children, the AOA recommends an eye exam every two years if no vision correction is required. Children who need eyeglasses or contact lenses should be examined annually or as recommended by their optometrist or ophthalmologist.

Early eye examinations are crucial to make sure children have a normal, healthy vision so they can perform better at schoolwork or play.

Early eye exams also are important because children need the following basic skills related to good eyesight for learning:
 

• Near vision
• Distance vision
• Binocular (two eyes) coordination
• Eye movement skills
• Focusing skills
• Peripheral awareness
• Hand-eye coordination

For these reasons, some states require a mandatory eye exam for all children entering school for the first time.

Scheduling Eye Exams for Your Child

The American Academy of Ophthalmology (AAO) says on its website that your family doctor or pediatrician likely will be the first medical professional to examine your child's eyes.