There are many misconceptions about pediatric vision care. Some of the misunderstanding comes from parents not understanding the visual needs of their children. They think that a kid's eye exam is going to be the same as their eye exam (well maybe the doctor will raise the chair up a little higher so the kid can see). Sadly, other misconceptions are perpetuated by eye care providers who do not feel comfortable seeing kids; so they tell parents to bring their kids in when they are older. Well let's get to the bottom of pediatric vision care.
1) When should you child get his or her eyes examined?
The American Optometric Association recommends that children have their first eye examination with an eyecare provider (optometrist or ophthalmologist) between six and twelve months of age – yes you read that correctly; 6-12 months, not years. The next eye examination for a normally-developing child with no identified vision conditions is 3-years-old. Following this visit, it is recommended that the child be seen again at 5-years-old. After entering school, it is beneficial for a child to received annual eye examinations to ensure that they are seeing clearly and that their visual system is functioning properly.
So, when should a child start having their eyes examined?
Each eye examination serves a slightly different purpose. The earlier eye examinations are meant to identify significant refractive errors (prescription), amblyopia (lazy eye), strabismus (eye turn), sight-threatening conditions, overall ocular health and vision conditions that will impair overall development. As the child develops, so should their visual system. Later eye examinations not only look at ocular health and prescription, but also ensure that the child is maintaining age-appropriate vision developmental milestones. From eye teaming to eye tracking, it is important that your child's vision is developing properly. As they enter school, eye examinations become increasingly important as your child's vision demands rise each and every academic year. Eye exams with a pediatric eye doctor can evaluate the visual skills that impact your child's ability to learn.
Do NOT wait for your child to complain about their vision. Most children assume that the way they see is 'normal' and will not complain. In younger years children can function rather well without 20/20 vision. This, however, impacts development and academic progress.
2) What conditions can be identified during a pediatric eye exam?
A comprehensive eye examination with a pediatric eye doctor looks very different than the eye examination that you receive as an adult. A residency-trained pediatric optometrist has the skill and training to modify testing to age-appropriate levels. They also have the knowledge to manage eye conditions specific to the pediatric population.
A pediatric eye exam can identify a number of vision conditions, including:
A pediatric eye examination is much more than a screening that quickly looks at a child's vision in the distance. This is why you should be selective when choosing an eye doctor for your child.
3) Who performs pediatric eye exams?
Many people claim to perform pediatric eye exams (or parents mistakenly think an eye exam has been performed when one has not been). Pediatric eye examinations should be performed by a residency-trained pediatric optometrist or a pediatric ophthalmologist.
Pediatricians do not perform pediatric eye exams. They may quickly do a vision screening that is designed to detect gross abnormalities, but they do not spend the time performing a pediatric eye examination.
Most eye doctors do not perform pediatric eye examinations the way a residency-trained pediatric optometrist is able to. The majority of optometrists perform primary care eye examinations and have schooling well suited to managing the eye and vision health of most adults and some children. A residency-trained pediatric optometrist has gone on to receive advanced training in the area of pediatric vision care. They are trained to diagnose and manage pediatric vision conditions (and can even do it before your child can speak or knows their alphabet).
Important: Many eye doctors say that they see kids or will go so far as to say they are a pediatric doctor, however they possess no advanced training in pediatric vision care. Be sure you ask for a residency-trained pediatric optometrist. Ask where the doctor received their residency-training and make sure you are seeing a doctor with the expertise to care for your child (not just one who likes kids or thinks it would be neat to see the whole family)
School nurses do not perform pediatric eye exams. Just like pediatricians, school nurses do a cursory screening of distance vision, they do not perform eye exams. A school vision screening is equivalent to the vision test you get at the DMV and serves much of the same purpose as you asking your child if they can see a sign when you are riding in the car together.
Primary care eye examinations are typically performed by optometrists, and a child's annual eye exams should be performed by a residency-trained pediatric optometrist. The specialized training that these doctors have received prepares them to properly care for pediatric patients. Pediatric eye examinations rely heavily on the clinical skills of the doctor (do you really want to trust your child answering 'which is better 1 or 2'?) and their knowledge of what is age-appropriate at your child's age. So when choosing an eye doctor for your child it is even more important that you are selective, as that doctor can impact your child's vision, development and academic progress.
Pediatric ophthalmologists typically see patients who are in need of surgery or have complex medical eye conditions. A pediatric optometrist will typically work with a pediatric ophthalmologist to manage complex cases requiring surgical care. Much like you have your primary care provider who occasionally refers you for tertiary care, your residency-trained pediatric optometrist will do the same for your child.
So remember, when choosing an eye doctor for your child do your research. Find a residency-trained pediatric optometrist who has the skill and knowledge to care for your child. Their vision, development and even academic success could rely on it.