Eye health resource
When Should Kids Have Their First Eye Exam?
Learn when babies and children should have comprehensive eye exams, what happens at a pediatric eye exam, and how Park Slope Eye's InfantSEE participation can help families start early.
Reviewed for accuracy by Justin Bazan, OD on .
A good first milestone for a comprehensive eye assessment is between 6 and 12 months of age. Babies do not need to know letters or tell us what they see for an eye doctor to learn a great deal about their vision, eye alignment, focusing, prescription, and eye health.
Park Slope Eye participates in InfantSEE. Qualifying InfantSEE infant eye assessments are available at no charge during the first year of life.
Recommended Eye Exam Schedule for Children
The American Optometric Association recommends the following schedule for children who are asymptomatic and considered low risk:
- Birth through age 2: a comprehensive eye assessment at 6 to 12 months.
- Ages 3 through 5: at least one comprehensive eye exam between ages 3 and 5.
- Ages 6 through 17: an exam before first grade and annually thereafter.
That schedule is a starting point, not a rule that applies identically to every child. A child with symptoms, a failed screening, a known eye condition, developmental or medical risk factors, significant family history, or a parent or pediatrician concern may need an exam sooner or more often.
Why Examine a Baby Who Cannot Read an Eye Chart?
Infant eye exams use age-appropriate, mostly objective methods. An optometrist can evaluate whether the eyes are aligned and moving together, how the pupils respond, whether each eye can fixate and follow, whether significant nearsightedness, farsightedness, or astigmatism is present, and whether the visible structures of the eyes appear healthy.
Early childhood is a period of rapid visual development. Identifying a meaningful prescription difference between the eyes, persistent eye misalignment, a structural problem, or another vision concern early gives families and doctors more time to respond appropriately.
What Happens at a Pediatric Eye Exam?
The exact examination changes with the child's age and abilities, but it can include:
- medical, birth, developmental, and family history;
- age-appropriate measurement of vision;
- assessment of eye alignment and eye movements;
- evaluation of focusing and how the eyes work together;
- measurement of refractive error — nearsightedness, farsightedness, and astigmatism;
- an eye-health examination; and
- dilation when it is clinically useful.
Older children often do very well with picture or symbol charts before they know letters. Many children around age 5 and older can also complete our Optos wide-angle retinal imaging, which takes a fast, non-contact photograph of much of the retina. Dilation is still recommended when symptoms, risk factors, or examination findings make it necessary.
What If My Child Is Becoming Nearsighted?
Myopia means nearsightedness: distance vision becomes blurry while near vision may still be clear. If a child's myopia is progressing, correcting the blur is only one part of the conversation.
Park Slope Eye offers myopia-management care that may include Ortho-K, low-dose atropine, or appropriate soft multifocal/myopia-control contact lenses depending on the child. No treatment can guarantee that myopia will stop progressing, so recommendations are individualized.
Vision Screenings Are Helpful, but They Are Not the Same as an Eye Exam
School and pediatric-office screenings are useful because they can identify some children who may need further evaluation. A screening, however, does not provide the same information as a comprehensive eye examination.
If your child has symptoms, failed a screening, has a known risk factor, or you simply have a concern about how they see, learn more about pediatric eye care at Park Slope Eye or book an appointment.
Originally published . Substantially updated .