When Should Children Get Their First Eye Exam?

According to Prevent Blindness America (PBA), the nation's leading volunteer eye health and safety organization, vision problems affect one in 20 preschoolers and one in four school-age children; undiagnosed, they can lead to learning problems as well as permanent loss of vision. Both PBA and the American Academy of Pediatrics (AAP) advise that vision exams begin by 3 or 4 years of age; however, specific problems warrant comprehensive exams at any age.

Earliest Eye Exams

• Because many eye disorders present themselves at birth and in a baby's first few months of life, the AAP recommends that pediatricians examine their patients' eyes at birth and at all subsequent well-visits. While not testing specific vision acuity, these routine exams look for possible disorders or diseases of the eyes.

Common Eye Problems

• Blocked tear ducts are common in newborns and infants; symptoms include excessive tearing in one or both eyes. Pediatricians will examine the eyes to rule out infection and advise parents on treatment.

  Strabismus is a condition in which an infant's eyes remain intermittently or constantly crossed or misaligned after two to three months of age. A pediatric ophthalmologist can confirm the suspected diagnosis of strabismus and set a treatment plan---usually involving corrective eyeglasses, eye drops, or surgery.

Eyelid Disorders

• Eyelid disorders can affect developing vision and should be examined by medical professionals.

  Ptosis, a droopy eyelid, may partially or completely block the eye, threatening vision; surgery is recommended when vision is in danger.

  Eyelid tumors on the upper eyelid, usually present at or shortly after birth, can cause glaucoma. Pediatric ophthalmologists will examine these periodically to make sure vision problems don't arise.

Rare but Serious Eye Problems

• Retinopathy of prematurity, or ROP, in which retinal blood vessels develop abnormally, specifically threatens premature infants; if not treated properly, it can cause blindness. Neonatologists routinely check premature infants for this condition at birth.

  Cataracts, while rare in infants and young children, are a leading cause of diminished sight and blindness. Infants born with cataracts---evident by a white reflection in the center of the pupil---usually have the affected lens surgically removed within their first month of life and are fitted with corrective lenses or eyeglasses; the rehabilitation of the affected eye lasts until the infant's eyes mature---at age 9 or older.

Common Vision Problems

• Nearsightedness---difficulty seeing faraway objects---is the most common visual problem in young children, according to the AAP. It's treated with corrective lenses---eyeglasses in the young, with the option of contact lenses in those 11 or older.

  Farsightedness---difficulty seeing up-close objects---is common in newborns and young children and usually corrects itself. If it persists, it can become evident when a child begins reading and suffers from eye strain or mild headaches. It's treated with corrective lenses.

  Astigmatism, an uneven curvature of the cornea or lens, can cause blurred vision---both near and far---and is treated with corrective lenses.

  Amblyopia, also known as lazy eye, develops when a child favors a strong eye over a weaker or injured eye. If not corrected by the time the child is six years old, according to the AAP, vision may be lost permanently in the weaker (unused) eye. Treatment involves using eye patches and/or blurring eye drops in the strong eye to force the use of the weaker one.