what age should your child get an eye exam

02/05/2025

Why Early Screening Matters

The first years of life are crucial for the development of vision in children. A newborn’s vision is blurry and beyond the first 6–7 years of age, it develops up to 10 years of age, where it is fully formed.In order not to underdiagnose visual problems, the American Academy of Ophthalmology and American Association for Pediatric Ophthalmology and Strabismus recommend several screenings:

• In the newborn, we can check basic things but mandatory to assess, like the “red reflex” — illuminate both eyes with a light, a red reflection in both eyes has to be seen, as in a flash of a photograph.
• If both or one of the two eyes does not have it, it should be checked immediately because it could be a cataract or a problem in the retina such as a tumor or alterations in the normal development of the eye.
• Also, we need to check the blink and the pupil response. Tearing or excessive blinking of the eye can be a sign of congenital glaucoma or obstructions in the lacrimal duct that should be assessed at an early age.

Vision Checks Between 6 to 12 Months

Between 6 to 12 months, we need to see again the tests mentioned before, and we can assess the alignment and normal movement of the eyes and normal evolution of the visual development.
 

1 to 3 Years: When to Rule Out Bigger Issues

Since the year to 36 months, if there is any suspicion of bad development of the vision, we can rule out lazy eye or refractive issues. But the most important thing is to perform a comprehensive eye exam, performed by an ophthalmologist before 5 years of age.

What the Comprehensive Exam Includes

This evaluation needs to include:

• Visual acuity adapted to the children’s age and collaboration
• Complete examination of the eye, cornea, iris, pupil, and of course retina
• Rule out refractive errors — usually, we perform this test using drops to dilate the pupil. This exam is mandatory to do in kids to assess the normal development of vision and the needing or not to wear glasses.

Why Children Don’t Complain About Vision

Surprisingly, children rarely complain of bad vision, probably because they don't know what normal vision is for other people, and they are able to adapt perfectly, even with very bad vision.

The Risk of Lazy Eye (Amblyopia)

Another problem that we face in children is the possibility of having a lazy eye. Lazy eye or amblyopia consists of poor vision development in one or both eyes. This can be solved in childhood, before 6–7 years of age — but after this period, there is no effective solution.