With so many other things to think about regarding your child's health and development, it's easy to overlook his or her eyesight, especially if there aren't any warning signs of a problem. Your child should have at least three vision screenings by the time they start school, according to the recommendations by the American Academy of Ophthalmology.
This doesn't necessarily mean you need to take your child to an ophthalmologist or optometrist right away, however. Most vision screenings are performed by pediatricians who refer parents of children with potential problems or risk factors to eye specialists.
Your child likely underwent a screening at birth by a pediatrician or family doctor. Newborn screenings look for signs of serious abnormalities and risk factors for vision problems. If any potential issues are identified, the newborn is referred to a pediatric ophthalmologist for further testing.
Your child's pediatrician should do a second vision screening when your baby is between six and 12 months old at a well-child visit. If you have any concerns about your baby's vision at any time -- like if he or she doesn't seem to be tracking objects, has constantly watering eyes or develops any visible abnormalities -- talk to the doctor about them right away.
Routine eye examinations for infants aren't painful or difficult. Your pediatrician will check your baby's response to light with a small flashlight and test his or her ability to track objects and perform other basic eye movements. The doctor will also examine the overall structure of your child's eye and eyelids to check for any irregularities.
Toddlers and Preschoolers
By the time your child is around 3 years old, your pediatrician will perform a more comprehensive vision screening or refer you to an ophthalmologist for further testing. At this age, the doctor will still check your child's ability to track objects and his or her response to light, just like an infant eye exam, but there will likely be further testing as well. This includes checking the alignment of your child's eyes and testing his or her vision with a picture chart if the child can communicate and cooperate with the doctor administering the test.
If your little one can't speak well or isn't in the mood to cooperate (as toddlers often aren't), an ophthalmologist can check your child's ability to focus both near and far with a technique called photoscreening. This testing method uses a special camera to evaluate your child's eyesight and doesn't require much cooperation. These tests also check for "lazy eye."
Children should have another vision screening before they start school to make sure they're seeing properly and will be able to learn to the best of their abilities. Your pediatrician will let you know if your child should see an ophthalmologist for testing, or you can request a referral if you're concerned about your child's eyesight and feel he or she needs more comprehensive testing. The testing methods are similar to those used for toddlers, though picture charts are more often used since children getting ready to start school can communicate and cooperate with the testing for a short time.