What to Expect at Your Child’s Eye Exam
Jordyn Tull & Elizabeth Chiu, Optometry StudentS
Did you know that it's recommended for a child to have their first eye exam as early as 6 months old? While your child may not seem to be struggling with their vision, it is important to get their eyes routinely checked and make sure they're reaching key visual milestones! Yearly eye exams are covered under OHIP for anyone aged 19 and under in Ontario, a great service to take advantage of throughout childhood until early adulthood.
What Are the Milestones associated with Vision?
As children grow, both their eyes and visual systems will reach various checkpoints in which new abilities developed over time. Many of the tests an optometrist will perform are centred around the development of these vision milestones. Optometrists will also assess the extent to which these developed abilities are utilized and if they fall within the expected range for their age groups. Here is an informative video about Vision Milestones and What Your Baby Sees!
What do Optometrists Look For & How Do They Assess Vision Milestones?
During the eye exam, your optometrist will assess four main things: visual acuity, binocularity, refraction and ocular health. To find out how well a child can see, eye doctors often use a letter or picture chart for visual acuity testing. For infants and toddlers who aren't able to use these charts yet, doctors use a test called preferential looking. It works by presenting a patterned image, like stripes, next to a blank one to see which the child looks toward, helping assess their vision even before they can speak or follow instructions.
Binocularity refers to when both eyes work together to form one image. When the eyes are in their natural position, the optometrist will ask you to track an object that is moved in various directions, then cover alternating eyes. This assesses how the muscles work together, eye tracking ability, hand-eye coordination and depth perception (stereopsis), each of which contribute to binocularity. Furthermore, it can reveal if your child has an eye turn (strabismus), or weak eye (amblyopia).
A refraction assesses if they are near-sighted, far-sighted, or have astigmatism and the extent of vision correction needed. Finally, the eye exam will also review eye health and ocular health concerns, starting from the front, including eyelids and the front surface of the eye (cornea, sclera & lens), to the back of the eye (the retina).
Infant and Toddler Eye Exams (6 months old to 3 years old)
During a comprehensive eye exam, your optometrist will assess visual acuity and binocularity using preferential viewing tests and objects or toys that attract your child's attention. Depth perception will also be evaluated with a booklet featuring images that seem to pop out.
Even at a young age, refraction can be done using a handheld tool called a retinoscope, which shines a bright light and is paired with a paddle containing various lenses, instead of the larger phoropter typically used to determine a prescription.
Near the end of the exam, the optometrist will use a special lens to examine the health of the retina at the back of the eye. Based on the results of these tests, the optometrist will assess your child's prescription and recommend vision correction if needed.
Here is a great video which demonstrates what Eye Exam for Infants may look like!
Eye Exams for Children (4 to 9 years old)
The eye exam for your child begins with a pre-test, where they’ll use an auto-refractor to get a basic prescription. In the optometrist’s office, the exam will build on similar tests they had as an infant, but with some updates. The core methods for checking how well your child’s eyes work together and how clearly they see remain the same, though now during refraction, your child will wear the "big glasses" (phoropter) to try different lenses and find the clearest one.
New parts of the exam may include color vision testing, where your child will look at a booklet of colorful dots or plates with various pigments. For eye health, the optometrist will use a slit lamp to closely examine the surface of the eyes and retina, making sure everything is in good shape.
Here is another great video which demonstrates what you can expect at your Children's Eye Exam!
Feel free to book an appointment with one of our optometrists at any time to begin your child’s eyecare journey or gain more information about their vision. To learn more, you can also check out our blog post “Ask the Doctor About Child's Eye Exams”.
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Images generated with ChatGPT (DALL·E) by OpenAI
