At what age should my child have his first eye exam?
A: The answer to this question varies widely. Premature infants, those under 1500
grams birth weight, need to have their eyes examined by 32 weeks of gestational
age or 4 weeks after birth depending on their gestational age at birth. These
children are then followed closely through their toddler years. Children with
any ocular abnormality, hearing deficit, or other neurologic or muscular problem
noted by the pediatrician should be examined as soon as possible. Children with
a family history of crossed eyes in childhood, "lazy eye" or any type of
strabismus should be examined by two years of age. In the absence of any
abnormalities or family history of strabismus, most children are examined
(screened) by the pediatrician (or family doctor) and referred as necessary.
Parents may elect to have their children seen by a pediatric ophthalmologist at
any age when there is an ocular question or concern.
What is a pediatric ophthalmologist?
A: A pediatric ophthalmologist is a medical doctor and surgeon who has completed
four years of medical school, a year of internship, three years of specialty
training in ophthalmology and an additional year of fellowship training in
pediatric eye disease. Pediatric ophthalmologists are trained to evaluate and
manage all eye problems in children.
My child sits very close to the TV. Is this a problem?
A: Many children sit very close to the television. That by itself is not a
cause for concern. Most normal children sit within several feet of the
television. If there are other signs of poor visual function, an eye exam is
My child does not yet know the alphabet. How can you evaluate his vision?
A: There are many tests of visual function which do not require a verbal
response from your child. The visual behavior or an eye can be compared to the
fellow eye to detect small differences. Picture charts, number charts, and other
tools are also used in young verbal children. In addition, objective
measurements of the eye will reveal if there is any refractive correction
without any responses from your child. The complete ophthalmic exam will reveal
any anatomical abnormalities that would impact a child's vision. The combination
of all these tools allows a fairly complete picture of a child's visual ability.
My child's eyes cross. Will she out grow this?
A: Most infants appear to have eyes that turn in. Because of the small infant
head and the wide nasal bridge, there is typically less sclera or white visible
on the inner part of the eye compared to the outer part. That illusion of
crossing disappears as the child grows and the head becomes larger. The pseudo
for false crossing has led to the old wives tale than eye crossing goes away.
True eye crossing, which occurs in about one of several thousand infants, does
not go away. If the eyes are indeed turned in or crossed, the child should be
seen by an ophthalmologist as soon as reasonably possible.
My child complains of frequent headaches. Is this an eye problem?
A: There are many different causes of headaches in children, from the simple to
the highly complex. The first step in the evaluation of headaches is to visit
the child's pediatrician. Many doctors will request a full eye exam to rule out
ocular causes of headaches. An eye exam may provide valuable insight into the
causes of some headaches. However, it is uncommon that there is an ocular cause
I am nearsighted and my husband is farsighted. Will my child need glasses?
A: Each of these conditions is often passed from the parent to the child. If
either parent started wearing glasses before kindergarten, all children should
be examined about 3 years of age or even sooner if the parents see either eye
turning in or if they suspect poor vision. Nearly all myopia starts during
elementary school so that the blurred vision can be detected by screening at the
school or the primary care doctor's office.
My child is having difficulty learning to read. Does she have a learning disability?
A: The diagnosis of a learning disability is in the realm of the education
professionals, teachers and educational psychologists. When this diagnosis is
made, an eye exam by a pediatric ophthalmologist is warranted to be certain that
there is no ocular cause for the poor reading. However, only rarely is an ocular cause found.