Are your Child's Eyes 'School Ready'?

The importance of back-to-school eye exams

As the last few weeks of August fly by, many parents (and reluctant children) are creating to-do lists in preparation for heading back to school. One item that should be included on everyone’s list is scheduling an eye exam before school starts.

Nearly 80% of classroom learning is vision-based. Children with vision challenges are more prone to falling behind. Uncorrected vision disorders can also impair development, lead to behavioral issues, and even cause permanent vision loss.

Children who can’t see well are also at a disadvantage out of the classroom. Phys Ed and sports require strong vision including depth perception, a wide field of vision, and clear distance vision. Without strong vision, children are more likely to be injured when being active and may shy away from physical activity simply because they’re not successful at it due to an unknown vision issue.

Because children’s vision changes frequently as they grow, they should see an optometrist for a screening evaluation on the schedule noted below, as recommended by the American Academy of Ophthalmology, and every year, or more frequently if they have specific problems or risk factors.

A vision screening is rapid eye exam. A child is “screened” for eye problems and referred to an ophthalmologist for a comprehensive exam, if needed. Your child’s vision can be screened by a:

pediatrician
family physician
optometrist
ophthalmologist
or other properly trained health care provider

Screenings are also offered at schools, community health centers, or community events.

Recommended Screenings: ages 3 to 5 years

The American Academy of Ophthalmology (AAO.org) recommends that between 3 and 5 years, a child’s vision and eye alignment should be checked. Visual acuity (sharpness of vision, like 20/20 for example) should be tested as soon as the child is old enough to read an eye chart.

Many children are somewhat farsighted (hyperopic), but can also see clearly even at distance. Most children will not require glasses or other vision correction. If the child struggles with the eye chart, photoscreening may be used to test vision.

Referral to an Ophthalmologist for a Comprehensive Eye Exam: ages 3 to 5 years

If your child’s screening reveals signs of:

misaligned eyes (strabismus)
"lazy eye” (amblyopia)
refractive errors (myopia, hyperopia, astigmatism)
or another focusing problem

Treatment for these problems should begin as soon as possible—getting early treatment for your child is the best thing you can do to protect their vision.

Recommended Screenings: ages 5 years and older

At 5, children should be screened for visual acuity and alignment. Nearsightedness (myopia) is the most common problem in this age group. It is corrected with eyeglasses, which can be prescribed by an optometrist or ophthalmologist.

Referral to an Ophthalmologist for a Comprehensive Eye Exam: ages 5 years and older

An ophthalmologist should examine a child with misaligned eyes or signs of other eye problems. Children treated with growth hormone therapy should have their eyes tested before and during treatment.

What’s the Difference Between Vision Screening and a Comprehensive Eye Exam?

A comprehensive eye exam diagnoses eye disease. Eye drops are used to dilate (widen) the pupil during the exam. This gives your ophthalmologist a fuller view inside the eyes. With dilation and other special testing, signs of eye disease are more evident.

The American Academy of Ophthalmology advises parents to seek a comprehensive eye exam if:

their child fails a vision screening
vision screening is inconclusive or cannot be done
referred by a pediatrician or school nurse
their child has a vision complaint or observed abnormal visual behavior or is at risk for developing eye problems. Children with medical conditions (such as Down syndrome, prematurity, juvenile idiopathic arthritis, neurofibromatosis) or a family history of amblyopia, strabismus, retinoblastoma, congenital cataracts or glaucoma are at higher risk for developing pediatric eye problems.
their child has a learning disability, developmental delay, neuropsychological condition or behavioral issue

The earlier a vision problem is detected and treated— including eyeglasses, contact lenses, and/or vision therapy—the more likely it is the treatment will be successful.

Even if your child receives an eye exam, you should keep an eye out for vision issues. Often, they happen so gradually that a child will not even notice.

Some signs your child may have a vision problem