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Your Child’s First Visit to the Eye Doctor: What to Expect

Children with poor vision can have a hard time learning while struggling to see to read and write.

In honor of Children’s Eye Health and Safety Month, we’re discussing the importance of vision screenings and starting regular eye exams for your child, so you can make informed choices about your child’s eye health.

Vision Screenings

Vision screenings are different from comprehensive eye exams. They are limited in scope and are meant to assess for indications that a more detailed evaluation is needed. They are normally part of a routine medical check-up by a pediatrician, family physician, or primary care provider. It is suggested for children to have vision screenings at the following ages:

Newborn: In the hospital nursery, the child’s eyelids, external eye, pupil, and red reflex are inspected. The red reflex is a reflection of light from the lining of the back of the eye. Abnormalities in this reflection can be an early indicator of eye disease.

Infancy: These screenings are done when the child is between six months old and 1 year old. This screening checks for how the eyes respond to light, evaluates the response of the pupils and assesses the child’s ability to focus on and follow a target.

Any abnormal signs during these routine vision screenings may warrant a child’s first visit to the eye doctor for a comprehensive eye exam.

Comprehensive Eye Exam

If the routine screenings performed during the first couple of years are normal, your child’s first comprehensive eye exam by an ophthalmologist or optometrist should be performed between 3 to 5 years of age. After the age of five, exams can take place every two years if no problems are detected and no vision correction is required. Keep in mind that children who need eyeglasses or contact lenses will have more frequent check-ups, normally once a year.

What to Expect During Your Child’s First Eye Doctor Visit

Your child’s first pediatric eye exam will involve a detailed case history, a full age-appropriate vision test, and an eye health examination.

The comprehensive pediatric eye exam includes assessment of visual acuity and refractive error (need for glasses) using an eye chart. Special symbols and pictures are used for children who do not yet know the alphabet. In addition, eye alignment, eye movement and tracking, depth perception, color vision, visual field are tested along with an assessment of all ocular structures, both inside and outside of the eye. More sophisticated testing is performed when necessary.

Following the exam, your doctor will discuss with you whether glasses are needed.

a view of dean mcgee's children's eyeglass center.

Conditions Your Eye Doctor Will Be Looking For

There are several common eye conditions your doctor looks for during the exam, and each affect your child’s ability to see clearly and focus on school work. Here’s a look at some of these common conditions.

Amblyopia: The vision in one or both eyes is reduced because the eye and the brain are not working together properly. This can be caused by strabismus (see below), the need for glasses, a cataract or other disease blocking entrance of light into the eye.

Strabismus: Also called “lazy eye” or “crossed eye”, strabismus refers to any misalignment of the eyes. It can sometimes be treated with glasses or exercises, but may require surgery on the muscles that control eye positioning and movement. An estimated 4% of the U.S. population has strabismus, according to the American Association for Pediatric Ophthalmology and Strabismus.

Tear duct obstruction: This prevents tears from draining through this system normally and may cause eye discharge or mattering.

Astigmatism: A condition in which objects at both distance and near appear blurred. This results from uneven curvature of the cornea and/or lens which prevents light rays from entering the eye from focusing to a single point on the retina, thereby causing blur. Astigmatism often occurs with myopia (nearsightedness) or hyperopia (farsightedness).

For a full list of common pediatric eye problems, see our breakdown here.

What Information Should I Have Prepared

It’s helpful for your eye doctor to know of any medical history, such as trauma to the eye or any previously failed vision screenings. Also, share if you’ve noticed any of the following symptoms -- frequent eye rubbing or blinking, or trouble maintaining eye contact or focus on specific objects. A summary of the child’s past medical history and current medications is important as well.

Family history of eye conditions is another key piece of information to have ready.

How to Keep Your Child Comfortable at The Eye Doctor

Anytime a child experiences something new, especially when it comes to doctor appointments, there will be some nervousness. However, there are several things you can do to help make this first appointment run smoothly and keep your child comfortable.

Schedule: Like most engagements involving your children, it's best to plan for when they are at their best. Try to schedule around nap and mealtime so your child will be fully rested and not hungry during the visit.

Bring toys: Bring items to keep them entertained, especially for the waiting room when anxiety could set in. Our pediatric waiting room has a fish tank, special play area, books, toys, and more.

Talk to your child: Communicating with children ahead of time will help ease their anxiety. Bring up what they can expect at the appointment, and even reading a book or watching a video about eye doctors may help. We suggest My Gran’s Glasses by Mary Bee Clark, an Oklahoma City resident and local artist. Her colorful and fun text displays a Gran’s eclectic glasses wardrobe. 100% of the author’s proceeds from My Gran’s Glasses are donated to the Dean McGee Eye Institute’s Bradley K. Farris, MD Global Eye Care Program. To order My Gran's Glasses please call Full Circle Bookstore at 405.842.2900 or 800.683.READ.

Pediatric Eye Care at Dean McGee

The Pediatric Ophthalmology and Strabismus Division specializes in all common pediatric eye conditions, such as amblyopia and strabismus, and less common conditions, such as cataract, glaucoma, and neurologic disease in children. Our team feels strongly that many vision problems can be successfully treated with early diagnosis and intervention — especially for growing children whose eyes are still developing.

View our pediatric page for a full list of our pediatric doctors and services at the Oklahoma Health Center in Oklahoma City and in Edmond. We want to help you and your child have the best school year yet by starting off with healthy eyes. Contact us today with any questions or to make an appointment.

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