The earliest age for the child to have his/her first eye exam is dependent on the existence of any signs that suggest eye abnormalities. These are usually discovered right after birth, by the paediatrician. In such cases, eye assessment and evaluation is mandatory, and should be performed as soon as possible by an experienced ophthalmologist.
For example, infants who need a prompt eye exam are those who have signs of congenital glaucoma (a condition where the eye pressure is remarkably high). Congenital glaucoma can be suspected if one, or both eyes are bigger in size than normal, with or without corneal cloudiness.
Other condition that should be looked at, is congenital cataract, where the crystalline lens of the infant’s eye is opaque.
A medical term called leukocoria (also white pupillary reflex) is an abnormal white reflection from the retina of the eye.
When leukocoria is detected, it might be an early sign of: congenital cataract, congenital glaucoma, or retinablastoma (an eye cancer that begins in the retina). In such cases, referral to the ophthalmologist, for a comprehensive eye exam, is essential.
In the absence of any apparent eye abnormalities, or associated risk factors, and according to the AOA, the first eye check up is recommended between 6-12 months of age.
How often should children have eye examinations?
After initial eye examination, between 6-12 months of age, children should have their eyes examined at age 3, and just before they enter the first grade - at about age 5 or 6.
School -aged children should have an eye exam at least every two years if no vision correction is required. Children who needed eye glasses should be examined annually or as recommended by their eye doctor.
What are some signs and symptoms that a child has eye problems?
Parents usually are the first to notice their kid eye problems, for example: misalignment of one eye from another (inward or outward deviation), white pupil in one eye, unequal eyelid contours, abnormal head posture. In such cases, a prompt eye assessment should be done regardless of the child age.
Furthermore, the presence of certain risk factors may necessitate more frequent examinations based on professional judgment. Factors placing an infant, toddler or child at significant risk for eye and vision problems include:
- Prematurity, low birth weight, prolonged supplemental oxygen at birth
- Family history of myopia, amblyopia, strabismus, retinoblastoma, congenital cataracts, metabolic or genetic disease.
- Infection of mother during pregnancy (e.g., rubella, toxoplasmosis, venereal disease, herpes, cytomegalovirus or human immunodeficiency virus)
- Maternal smoking, use of alcohol or illicit drug use during pregnancy
- Difficult or assisted labor, which may be associated with fetal distress
- High or progressive refractive error
- Known or suspected neurodevelopmental disorders
- Systemic health conditions with potential ocular manifestations
Why do children need to have their eyes examined more often than adults?
One of the most important and common problems in children, is lazy eye (known also as amblyopia), in which, one eye vision is weaker than the other.
Lazy eye should be addressed and treated within the first decade of life, or the child will end up having a permanent impaired vision through out his/her life.
Children with anisometropia (a condition that occurs when the eyes have varying refractive powers, which can cause eyes to focus unevenly) can easily develop lazy eye. Moreover, kids with crossed eyes can also have a lazy eye in their deviated eye if not corrected early in life.
Short sightedness (myopia), is a progressive condition, with its pick of progression, is right before, and during puberty. School aged children with myopia can suffer easily from their lack of far vision, that can affect their social and education skills.
For the reasons above, children need to have their eyes examined more often than adults.