Good vision is essential for proper physical development and educational progress in growing children. The visual system in the young child is not fully mature. Equal input from both eyes is required for proper development of the visual centers in the brain. If a growing child’s eye does not provide a clear focused image to the developing brain, then permanent irreversible loss of vision may result. This is called amblyopia ("lazy eye"). Amblyopia is typically caused by an unrecognized need for eyeglasses and/or misaligned eyes (strabismus). Early detection provides the best opportunity for effective, inexpensive treatment.
In general, infants should be screened by the primary care physician shortly after birth and at routine well child exams. Any child with an abnormal test result should have a comprehensive evaluation by an ophthalmologist. Additionally, infants considered at higher risk for eye problems, such as those with prematurity, neuro-developmental delay, or a family history of childhood eye disease, should have a comprehensive evaluation by an ophthalmologist during infancy. If routine screening is normal during the first two years, the first comprehensive evaluation by an ophthalmologist should be around three years of age. Subsequent exams occur periodically throughout the school years, or more frequently if needed.
The comprehensive pediatric eye exam includes assessment of the visual acuity, refractive error (need for glasses), eye alignment, eye movement and tracking, depth perception, color vision, visual field, and assessment of all ocular structures. Additional sophisticated testing is performed when necessary.