What to expect: Your child’s first eye exam

Ocular examination of the health of your child’s eyes, including the cornea, iris, lens, retina and eyelids

When meeting with your child’s eye doctor for the first time, be prepared to answer questions about your child’s birth history (including any complications during pregnancy or delivery), birth weight, and whether they were born full-term.

Your doctor will also ask questions regarding family history of ocular disease, and your child’s medical history— including previous eye problems, treatments or surgeries, current medications and any allergies they may have.

Be sure to tell your doctor about any delay in motor development, and if you have noticed:

       Frequent eye rubbing or blinking

       Difficulty maintaining eye contact

       Poor tracking skills

It is also important to mention if your child has failed a vision screening conducted by their school or pediatrician.


Eye testing for infants (6 months to 2 years)

Babies by six months of age are tested for eye focusing skills, colour vision and depth perception. Your eye doctor will typically use three different tests to determine whether your baby’s eyes are developing normally.

1.      Pupil responses. This test will measure your baby’s pupil response (opening and closing) in the presence or absence of light.

2.      Fixate and follow. This test will measure your baby’s ability to fixate on and follow an object as it moves. The ability to fixate on an object usually develops within the first month of birth, while the ability to follow an object typically develops by three months of age.

3.      Preferential looking. This test will measure your baby’s vision, using special cards that are blank on one side and striped on the other, to attract the baby’s gaze.

Eye exams for preschool children (2 to 5 years) 

At this age, children are learning to colour in, draw, cut paper, stack blocks, build with Lego pieces, play with balls, and more!

A comprehensive exam for preschool children usually includes a series of tests for:

       Visual acuity

       Lazy eye

       Stereopsis (3D vision)

       Eye tracking


       Colour vision

       Ocular health

All of these visual skills are vitally important for the healthy development of an infant and to prepare them for the school years ahead.

Young children are constantly learning new skills that will prepare them for when they learn to read and write. Visual skills, such as, visual perceptual skills, eye-hand coordination, fine motor skills, etc., are also essential for learning and academic success.

If you notice that your child is showing any signs of developmental delay, or if your child has difficulty recognizing shapes, colours, numbers, or letters,  inform your eye doctor— a developmental delay may signal a vision problem.

LEA symbols are used to test visual acuity for young children who are unable to identify the letters on an eye chart. These symbols include an apple, house, square, and circle. Your child will be asked to identify these symbols, allowing your eye doctor to measure how well your child sees both near and distant.

Random dot stereopsis measures your child’s 3D vision— this is an indication of how well your child’s eyes work together. This test uses a chart with special patterns of dots and 3-D glasses.

Assessment of visual skills to rule out the presence of:

o   Amblyopia— also known as lazy eye

o   Strabismus— also known as crossed-eyes

o   Convergence insufficiency— the inability to view near objects easily

o   Focusing difficulties

o   Poor depth perception

Colour vision is examined using pictures with specific colors to determine if your child can discriminate between colours— the most common assessment is called the Ishihara Test.

Retinoscopy is a technique used to obtain an objective measurement of a refractive error. The doctor uses a retinoscope to shine light into the child’s eye, and then observes the reflection (reflex) off their retina. This test measures any refractive error such as myopia, that might be affecting your child’s vision.

Ocular examination of the health of your child’s eyes, including the cornea, iris, lens, retina and eyelids.

Source: https://www.optometrists.org/childrens-vision/guide-to-childrens-eye-exams/pediatric-eye-exams-2