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Does your child have hidden vision problems?

You take your child to the eye doctor for a routine checkup, and are happy when the doctor announces that her vision is 20/20. Perfect, right? Not necessarily.

Little girl wearing glasses |

Photo credit: Anne-Sophie Bost/PhotoAlto Agency RF Collections/Getty Images

Have you scheduled an eye exam for your child yet? Many moms assume that eye exams are just something for older, elementary-age kids, and rarely even think about their child’s vision. There is a recommended age at which your child should have a comprehensive eye exam, and it’s earlier than you might think. But a routine eye exam may not capture everything about how your child’s eyes are functioning — and we found out why.

Recommended schedule

Just as there are for routine, well-child checkups, there are recommended ages at which your child’s eyes should be examined. Both the American Academy of Pediatrics and the American Academy of Ophthalmology recommend the following schedule.

  • Newborn — Before leaving the hospital, all newborn babies should have their eyes checked. Doctors are looking for infections, defects of any kind, cataracts or glaucoma. Premature babies are especially susceptible, as are babies who were given oxygen for an extended period and babies dealing with multiple medical issues.
  • 6 months — In conjunction with each of the well-child visits, your pediatrician will check your child’s general eye health, how his vision is developing and how his eyes appear to be aligning with each other.
  • 3 to 4 years — At some point between the ages of 3 and 4, your child’s eyes and vision should be screened for any possible abnormalities that may cause problems later.
  • 5 years and older — Your child’s regular doctor should be checking vision in each eye separately every year. If a problem is noted during one of these routine eye exams, your child’s pediatrician will likely refer you to a pediatric ophthalmologist, who specializes in children’s eye problems.

What to watch for

Aside from the pediatrician checking the general health of the eyes, what should parents be on the lookout for? Tracking — the ability to follow a moving object with the eyes — is a skill babies older than 3 months should possess. If you notice that your baby or youngster isn’t able to follow a moving object well with just her eyes, ask the pediatrician about it at your next exam.

In babies younger than 4 months old, you will often notice that their eyes seem a bit misaligned (called strabismus), possibly drifting off to one side or crossing inward a bit. In young babies this is common, but if this persists past the age of 4 months, consult your pediatrician. Signs of a lazy eye (called amblyopia) may not always be obvious to you — and your youngster may not even complain of eye problems, since he doesn’t know any different. These problems are easier to address the earlier they are caught, which is why parents should make sure to follow the recommended vision screening schedule.

Does your child need glasses? >>

Why 20/20 isn’t always perfect

Your child’s eye exams all come back good — so you don’t need to fret over her eyes. Or do you? If your child is having difficulties with reading at school or when doing homework, it could be her eyes. “All too often, struggles with reading are a result of an undetected vision problem,” says Dr. Hilary Gesford, an optometrist specializing in pediatrics and vision therapy. “One out of every four children has a learning-related vision problem, despite the fact that the majority of these kids can see 20/20,” she adds.

Problems related to reading that may not be detected during a regular eye exam include skipping words while reading, using a finger to follow the words on the page or rereading a line over and over. However, an optometrist who has special training in vision therapy has ways to detect issues such as these that may be a factor in your child’s reading frustration. You can’t assume that your child is even aware that her vision is wonky, since she likely thinks that everyone sees things the same way she does.

Beyond the patch

Eye therapy used to involve nothing more techie than an eye patch on the “good” eye, forcing the other eye to work harder. Fast forward to today’s vision therapy, which retrains the eyes and brain to work as a team. Vision therapy is a non-surgical treatment that is considered highly effective for many vision-related issues. “Vision therapy is individualized to the needs of each patient, and because of this flexibility, our ability to treat and ‘retrain’ the brain around many problems is greatly enhanced,” shares Dr. Gesford. By retraining the brain to work with both eyes as it is supposed to, patients can see a marked improvement, which encourages them to continue.

If your child is struggling with reading or seems to be having vision-related issues, don’t wait — schedule an appointment with a pediatric vision specialist and see if his vision may be the issue.

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