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When should my child get an eye exam?

pediatric eye exam

When should my child get an eye exam?

Just like adults, children need to have their eyes examined. This begins at birth and continues throughout the child’s life on into adulthood. However, many parents are not equipped with the proper knowledge on when their children need to be seen for an eye exam. Following are my recommendations for when a child needs to be screened, and what is looked for at each of the stages.

The first eye exam of a child’s life should be done either right at or shortly after birth. This is especially true for children who were born premature and have very low birth weight. This is mainly done to screen for a disease of the retina called retinopathy of prematurity (ROP), in which the retina does not develop properly as a result of the child receiving high levels of oxygen. Although rarer today due to oxygen levels being monitored more closely, it is still a concern for premature babies.

The next level of eye exam that I would recommend would be at six months of age. At this stage, your pediatric eye doctor will check your child’s basic visual abilities by making them look at lights, respond to colors, and be able to follow a moving object. The child’s ocular alignment will also be measured to ensure that your child does not have strabismus, a constant inward or outward turning of one or both eyes. Parents are encouraged to look for these findings at home, as swift intervention with surgery to align the eyes at this stage is crucial for their ocular and visual development. Lastly, at this stage it is imperative for parents to be on the lookout for retinoblastoma, and primary cancer of the eye found in children. Sometimes it can be seen as a white reflex in the pupil, but is not always. Any baby or child with a white reflex accompanied by an eye turn MUST be seen immediately by an eye doctor, as retinoblastoma can lead to not only loss of the eye, but loss of life.

After the six month exam, I usually recommend another exam around 5 years old, then yearly afterwards. There are several reasons for this gap. Firstly, any parent with a 2-4 year old knows that it’s difficult for them to sit still for anything, let alone an eye exam. Trying to examine this young of a patient is frustrating for the doctor, the parent, and the child. Nobody wins. By 5 years old (around kindergarten age), children are typically able to respond to questions asked and can (usually) concentrate on the task at hand. It is at this stage that their eyes will be measured for a prescription for glasses, and checked for amblyopia, common known as a “lazy eye”. Detected early enough, amblyopia can be treated properly under close observation by the eye doctor.

The above listed recommendations are solely one doctor’s opinion of frequency of eye exams for children. The various medical bodies in pediatrics, ophthalmology, and optometry have different guidelines regarding exam frequency, but agree that while it is not essential that a healthy child’s eyes be examined every year, those with a personal history or family history of inheritable eye disease be followed more closely. 

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Saturday, 25 September 2021

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