How Vision is Tested in Young Children

Julie Bitely

| 3 min read

Little girl wearing glasses that are too big for her
When it was recommended that our youngest daughter see an eye doctor, I really didn’t understand how the process would work. I mean, how do you test the vision of a child who can’t yet read the eye chart? I quickly learned that a pediatric ophthalmologist’s office is way different (and more fun) than my previous experiences visiting the eye doctor. Here’s an explainer on how eye exams work for young children, in case you’re facing a visit with your little one. No ABCs, yet? No problem Pediatric eye doctors use a variety of methods to test little eyes.
  • They can use light to test a baby’s pupil responses. The way the pupils react to light could uncover nervous system issues. They will also likely check to see how well your child’s eyes are able to follow a moving object.
  • When our daughter was really young, our eye doctor used cards with stripes on them to administer a preferential looking test, which measures visual acuity, or how well she could see. The cards have a striped side and a side that’s gray. Babies and toddlers too young to identify pictures or letters will tend to look at the striped side. The smaller the stripes they can see, the better their visual acuity.
  • Once she was older and could identify shapes verbally, she was able to “read” the pictures on an eye chart designed just for kids. Instead of letters, her doctor’s office had a chart with a house, tree, flower and other familiar shapes.
  • Your child will likely be asked to cover one eye while they focus on something across the room and then close up. This helps the doctor check the alignment of your toddler’s eyes, or how well they work together.
  • Additionally, part of the eye exam is spent examining the overall health of the child’s eyes. The eye doctor will visually examine the eyes and may use drops to dilate the pupils. This allows the back of the eye to be examined using lights and lenses.
  • If your child’s eye doctor determines they need glasses, they might use an autorefractor, a machine that can help identify the correct prescription.
Many pediatric ophthalmologists use tools and toys to keep kids engaged and entertained throughout the exam. Our daughter’s eye doctor relied on a television playing Veggie Tales, wands that lit up and sparkled, and lots of verbal encouragement and affirmation when she followed a command. She also encouraged my husband and I to hold our daughter on our laps for the exams so she would feel comfortable and supported. When should kids visit the eye doctor? The American Optometric Association recommends that all children have professional eye exams at regular intervals: between the ages of 6 to 12 months, at least once between 3 and 5 years of age and once before they start first grade and annually thereafter. The organization warns that vision screenings can miss certain vision problems and urge parents to schedule a comprehensive eye and vision exam. Before the eye exam appointment, talk to your child about what will likely take place and assure them that you will be right by their side. You can even show them this video from VSP Vision Care of baby AJ getting his first eye exam to show them they can do it, too. If you found this post helpful, you may also enjoy:
Photo credit: Melpomenem

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