An interesting question is how a child can have their eyes tested when they are under reading age. Standard eyecharts rely upon the patient reading a series of specially aligned letters which for a young child are just shapes. Eye doctors are trained to use a number of methods described below to test for good eye health of little ones. A newborn baby has an estimated visual acuity of 20/400, developing to 20/20 by the age of 2 years old, but if they do not have good eyesight by the time they enter full time education, this can lead to them falling behind early on in their education and learning. Unfortunately a child does not know what good vision is by comparison, so they are unlikely to complain themselves, they simply appear to be slow learners. An estimated 5-10% of preschoolers have vision problems and early identification can be crucial.
At What Ages should Regular Eye Tests be Taken?
A qualified and experienced eye doctor can perform an eye examination on a child as young as 6 months old. According to the American Optometric Association (AOA) this is the age a child should have their first eye examination. This should be followed with a check up at 3 years of age and again before entering first grade. After that, the AOA recommends that school age children are tested every 2 years if no visual correction is needed. Those with eyeglasses should follow the doctor's individual recommendations.
Testing the under 1's
Babies should be able to see as well as adults in terms of focusing ability, color vision, and depth perception by three or four months of age. To assess whether your baby's eyes are developing normally, the doctor typically will use the following tests:
Testing pupil response to bright lights
Following an object such as a light as it moves. Infants should be able to fixate and follow an object by the time they are 3 months old. Preferential looking tests use cards that are blank on one side and stripes on the other to attract the gaze of an infant. This is to test for vision capabilities.
Testing the under 5's
In determining the eyesight of a young child the doctor usually has some objective tests and some subjective tests such as which one is better, one or two, to confirm the end result. When the child is at such a young age it would be difficult to get accurate response from the child so the doctor relies on the objective tests they perform to achieve the end result. As the child becomes older, the exams become much easier because not only is the doctor able to achieve the objective result, they can also obtain a response from the child to confirm the prescription. An older child will be tested using the following:
- Symbols such as a house or an apple
- Retinoscopy which shines a light onto the retina to help doctors determine an eyeglass prescription
- Dot patterns to measure how each eye seems in comparison to the other eye.
If eye problems are suspected during routine physical examinations, a referral might be made to an ophthalmologist or optometrist for further evaluation. Eye doctors have specific equipment and training to assist them with spotting potential vision problems. Be sure to tell your eye doctor if your child has a history of premature birth, has delayed motor development, engages in frequent eye rubbing, blinks excessively, fails to maintain eye contact, cannot maintain a gaze while looking at objects, has poor eye tracking skills or has failed a pediatrician or pre-school vision screening.
First Signs of Poor Eyesight at 5+
Signs and symptoms to watch out for in children if they have any vision problem include the following:
- Holding things very close to read
- Turning their heads when reading
- Rubbing their eyes frequently
- Squinting or straining their eyes
- Complaining of tiredness
- Poor performance at school
- Skipping lines when reading or does not like reading
In the event of any of the above it would be a good idea to get your child a thorough eye exam. It is a simple way to eliminate the possible cause of needing glasses, which can quickly and easily be rectified. There are many conditions that can only be corrected at a young age. Early detection is essential to achieve the best vision possible for your child.
What are Doctors Testing For?
Eye doctors are trained to spot amblyopia or lazy eye, which may be corrected using an eye patch; crossed or misalignment of the eyes; convergence of the eyes; focusing; color vision and depth perception. The doctor will also check for general eye health by looking for cloudiness in the cornea, iris and lens, and checking for any discharge or swelling.
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