What happens at a kid’s eye exam?

An eye exam can seem scary for a child, especially if it’s their first time. Not knowing what to expect and the fear of needing glasses can equally play into their anxiety. Of course, some kids may be more curious than they are afraid of an eye exam.

Whatever the case may be, here’s what your child can expect in their first eye exam, and how to help them understand why it’s important to have one.

What happens during a child’s eye exam?

Several tests will be administered during your child’s eye exam to check the sharpness of their vision, look for alignment problems and more. If a vision condition is found during the exam, the doctor will make a diagnosis and recommend the best method of treatment or correction.

One of the most common eye conditions in children is myopia (nearsightedness), a refractive error that makes faraway objects appear blurry. In fact, about 5% of preschool children have the condition, and about 9% of school-aged kids have it as well. Because it’s so common, screening for myopia will be a primary focus of the eye exam. 

Alternatively, children may present with uncorrected hyperopia (farsightedness) and/or astigmatism, which also impact vision. 

Other tests are done to make sure your child’s eyes are aligned correctly and that they move in sync with each other. Proper eye alignment affects academic performance as well as visual comfort. 

It’s important to note that eye exams can include different evaluations for each child depending on age, medical history and your family’s medical history. Many vision diagnoses are hereditary.

Watch our video on the importance of eye exams for children.

What kind of vision tests will your child be given?

An initial vision screening is made to make sure your child’s eyes are functioning properly. How are the tests performed to check your child’s vision?

Visual acuity testing 

Visual acuity is the sharpness of vision. Testing this involves an eye chart made up of letters or symbols of varying sizes. Your child will be asked to read both large and small figures from the charts both at a distance and close up. 

Young children who can’t identify letters yet may be asked to identify pictures of familiar objects instead of reading from an eye chart. This may include objects such as apples, houses, squares and circles. 

Vision evaluation can help to detect uncorrected refractive error and/or amblyopia. Amblyopia is reduced vision in one or both eyes due to non-disease factors.

Eye alignment testing 

Eyes should work together as a team and move in sync. If they don’t, a condition such as strabismus (crossed eyes) or amblyopia (lazy eye) may be present.

To check for these conditions, the eye doctor will have your child follow a light or a toy with just their eyes. Your child may have an alignment problem if their eyes don’t follow the object together, or if they move back and forth during the test. 

When an eye alignment problem is found early, there is a better prognosis for treatment. Eye exams in children enable early intervention and improved outcomes. 

Other testing

Children may be given eye drops that dilate the pupils. This is to help the eye doctor view the internal structures of the eye. This includes the retina, blood vessels and the optic nerve to ensure they are functioning properly.

The drops also relax the focusing power of the eye muscles, which can help the doctor identify refractive errors. Refractive errors include myopia (nearsightedness), hyperopia (farsightedness) and astigmatism. A dilated examination of a child’s refractive error often allows for a more accurate assessment.

Some children are afraid of eye drops. Your practitioner will let them know that the drops may sting a little. They may also cause their vision to feel blurry or sensitive. But this is temporary. The blur can last anywhere from four to 24 hours based on the strength of the drops used. 

It is important that parents are honest with their child but do not build up fear around the administration of eye drops. 

Your child’s eye doctor may also test for color blindness and depth perception, as well as various eye diseases if they run in your family.

How to prepare your child for their first eye exam

It’s difficult to prepare infants for their first eye exam. Comforting them by talking to them and allowing them to sit in their parent’s lap during the exam can make the process easier. Pediatric eye doctors are familiar with what to expect from a baby during their first eye exam, so they’ll be understanding of your child’s behavior. 

Older children should be encouraged to ask questions and be honest about their vision during their exam. Let them know that a vision evaluation is not a test and that getting things “wrong” is the key to diagnosing a vision problem. 

Is your child worried they might need glasses? Get them excited about their cool new accessory. Let them know that they can choose their very own pair of glasses. You might also reassure them that they’ll be able to see and function much better when they start wearing them.

How to help your child understand their vision problem 

Refractive error correction is the most common treatment in children 5 and older. If your child needs glasses or contacts, remind them that there are many other kids just like them. If your child has a more serious vision condition, ask their eye doctor to help explain what might be wrong in simple terms. 

Since vision changes as it develops throughout childhood, encourage your child to speak up about any problems they experience. This includes common vision symptoms such as headaches, eye strain and blurred vision. 

Also consider that many children experience these symptoms but may not convey them to their parents. Reassure your child that it’s always okay to ask questions about their eyesight.

Why is an eye exam important for your child?

Comprehensive eye exams help doctors understand your child’s vision and if they have any problems that should be corrected. A problem with your child’s eyesight can disrupt their academic success, safety and even parts of their development. 

More specifically, children’s eye exams help ensure your child has important vision skills that are necessary for their learning and development. Visual acuity (sharpness of vision), eye teaming skills and proper eye movement can all contribute to academic success.

Eye exams are also necessary to check for any eye diseases that may be present and treat them quickly. This is especially important for developmental eye conditions, which need to be corrected promptly to prevent struggles in the future.

When should your child have their first eye exam?

Experts recommend that children have their first comprehensive eye exam at 6 months of age to look for initial vision problems in the first year of life.

Children should have their eyes checked again at age 3 and again at age 5 or 6, just before they start first grade. 

How often should these exams take place? Doctors suggest once a year for any school-age child or younger child with a visual diagnosis. In today’s world of digital excess and visual strain, a yearly eye exam is a key to visual health.  

READ NEXT: ​​How children's eye exams differ from an adult’s eye exam 

Page published on Tuesday, March 15, 2022

Medically reviewed on Friday, February 11, 2022