Pediatric Q&A

From what age should a parent be bringing in their children for an eye exam?

According to the AOA infants should have their first eye exam at 6 months of age, at 3 and then again at 5-6 years old.

Why is it important to bring a child in from such a young age?

Some vision problems are best treated if detected and corrected early as possible. Early detection of children’s visual problems is essential to make sure your children have the visual skills needed to do well in school, sports and other activities.

What is the difference in terms of the examination process when you are checking the eyes of young children?

Specifics of how eye exams are conducted depend on the child’s age and will usually includeA full eye exam will test your child's near and distance vision, eye movement, eye teaming, focusing ability, check for eye turns, lazy eye and peripheral awareness.

Visual testing of near and distance vision.
Eye Alignment and ocular motor skills.
Checking overall health of the anterior structures in the eye as well as the posterior structures behind the eye.

Are there any signs that parents should be looking out for that would point them to making an appointment with their optometrist?

Yes. Delayed motor development, frequent eye rubbing, excessive blinking, failure to make eye contact, turning of an eye, poor eye tracking and headaches.

Do you find that some parents can express hesitancy in bringing in young children? What causes that hesitation?

Yes. They feel if the child doesn’t know the alphabet or cannot communicate they will not be able to have an eye exam. This is not true. We can use other testing methods in order to gather the information and complete the eye exam.

How does school play a role in this?

Most schools will do an eye screening but this usually only tests the child’s distance vision If your child is struggling to read or finding it difficult to remain on task, the cause may be an undetected vision problem, even if your child's eyesight is 20/20 and he's passed the school's vision screening.

Do you have issues with children that are shy or intimidated in the office, and how do you work with that?

Absolutely. We try to make the experience as positive as possible. Sometimes we will even make a game out of the exam.

Can you recall any particular story of a child that came into your office, in which you were able to detect an issue early on and therefore make a difference in that child's eye health?

I had a extremely shy 9 year old boy that was brought in by his parent for a “routine” eye exam. The parent said that the child had no vision problems and that there were no vision issues in the family. The boy had passed his school vision screening. When I started asking more questions, we found out that the boy was placed in special reading, was diagnosed with ADD and was told he had a learning disability. The parent stated that the boy suffered from extreme frustration during school and when trying to do homework.

When we did the exam the boy did have 20/20 distance vision, however he was found to have extremely poor teaming of his eyes and severely reduced focusing ability. Once we provided him with some glasses and did some eye exercises his grades went up, he no longer had to take medication for his ADD and was not labeled as having a learning disability. His parents could not believe the changes in their son. They couldn’t understand why the child didn’t tell them he couldn’t see. I told them that he didn’t know any better. To him this was normal.

Angelo Marino, OD