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Does your child need glasses? Here’s what every parent should know about eye testing

A comprehensive eye exam for a child should include a thorough assessment of both vision function and ocular health. If a vision problem goes undiagnosed or uncorrected, the school day can become unnecessarily challenging and impede learning success.
A comprehensive eye exam for a child should include a thorough assessment of both vision function and ocular health. If a vision problem goes undiagnosed or uncorrected, the school day can become unnecessarily challenging and impede learning success. Getty Images

Has your child had his or her first eye exam? If you think it’s too early, you could be mistaken. For exactly when a child should be tested, we tapped the expertise of Kelly K. Larsen, doctor of optometry at Mt. Baker Vision Clinic.

Larsen is a member of the Fellows of the American Academy of Optometry, recognized by her colleagues as a knowledgeable and experienced professional who has met the high standards of professional competence in a broad range of issues related to eye care.

Question: When should a child have his or her first eye exam?

Answer: Your child should have his or her first comprehensive eye health exam between the ages of 6 months and 3 years old, and then again before entering kindergarten.

However, a child should be evaluated immediately if you are concerned that they are not experiencing their visual world in a clear and comfortable way. Parents have an amazing intuition when it comes to their kids’ health and can often pick up on subtle things by “trusting their gut.”

While this instinct serves well, there are conditions that any parent can miss that eye doctors can pick up on during routine exams.

Q: How do you test children who cannot yet read?

A: The visual acuity test used to measure a person’s subjective vision is selected based both on their ability to recognize the character and to verbalize their answer. We will use charts with pictures or shapes for kids who have not yet mastered their letters.

For infants, younger or non-verbal children, we use objective testing that does not require a response from the patient to assess potential acuity, eye-teaming and vision balance.

Q: What are some signs parents should look for to determine if their child needs glasses?

A: A child who is experiencing difficulty due to an uncorrected vision problem often will not tell their parents or guardians that they have trouble seeing. They will try to make the visual tasks easier by squinting, holding reading material closer or moving closer to the television screen.

A constant or occasional turn of one or both eyes is another sign that a child is having a vision challenge. Children who complain of frequent headaches, aggressively rub their eyes or often cover or close one eye might also be experiencing a vision problem.

Q: Do you screen children for anything in particular?

A: A comprehensive eye exam for a pediatric patient should include a thorough assessment of both vision function and ocular health. We want to make sure the child is able to see clearly with each eye and that the eyes team well together.

Specialty testing allows for the diagnosis of color vision deficiencies, reduced depth-perception, amblyopia (“lazy eye”) and strabismus (“eye turn”).

A pediatric ocular health assessment is similar to an adult’s; although the tests might be modified to accommodate our smaller patients. We check for risk of eye disease including glaucoma, cataracts and retinal diseases.

Q: Why is eyesight so critical for education?

A: Early comprehensive eye exams are important. A child needs the following basic visual skills for learning: distance vision, near vision, binocularity (eye teaming), focusing, peripheral awareness, eye/hand coordination.

I often liken the vision demands at school to running a race. If a child has an uncorrected vision problem, then he or she runs the race with a 20-pound weight on their back. If a vision problem goes undiagnosed or uncorrected the school day can become unnecessarily challenging. This can impede learning success.

Q: What is the biggest mistake parents make when it comes to children and eye care?

A: A common mistake is assuming that the short vision screenings that take place at school or in the pediatrician’s office are equivalent to a comprehensive eye exam with an eye care professional. These screenings, while very useful, are not sensitive enough to detect all vision problems and they do not include an assessment of ocular health.

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