Your child’s vision is an important part of how they learn, play, grow, and develop. Regular eye exams allow your optometrist to monitor and detect visual issues before they become a larger problem.

But what happens during a kid’s eye exam? Simply put, an eye professional will go through a series of tests to ensure your child’s eyes and vision are developing normally. During a kid’s eye exam, you can expect the use of tools such as a phoropter and/or an autorefractor and vision tests like a refraction assessment or visual acuity test to determine if any visual conditions are present. 

The Importance of a Regular Eye Exam

Preventive care is essential in protecting your child’s eyes. It means catching problems before they become bigger issues. If caught early enough, some vision problems (like myopia or nearsightedness) can be slowed or stopped from progressing with proper myopia management plans.

Sometimes a learning or reading issue can be traced back to a vision problem such as strabismus or amblyopia, where vision therapy may help. Proper eye health will help set your children up for success in learning as well as participation in extracurricular activities.

It’s not as simple as a single eye exam either. Because kids’ eyes are always changing, new issues can pop up quickly. If that happens, your eye doctor can help you and your child develop a plan that best suits your child’s eye and vision needs.

How Often Should You Book a Kids Eye Exam? 

The Canadian Association of Optometrists has released the following information about the frequency at which a child should be getting an eye exam:

• The first eye exam should be between 6–9 months old
• One exam between 2–5 years old
• Annual exams from 6–19 years old

The frequency of getting an eye exam may change for your child based on several related factors. Here are a few reasons why your child might need an eye exam sooner or more frequently:

• Doctor’s recommendation 
• Family history of eye-related issues 
• Squinting or frequent eye rubbing 
• Difficulty with reading or seeing things that are farther away 
• Headaches or discomfort in their eyes 

If your child is experiencing any of these symptoms, consider booking an appointment and getting their eyes checked today. OHIP covers annual eye exams for kids up to 19 years old.

Vision Screenings vs Eye Exams

Some schools provide vision screenings for their students. A vision screening tests visual acuity (how well your child can see up close and far away) by having them read the letters on a Snellen chart.

Vision screenings, however, are not a substitute for an eye exam. 

Visiting the eye doctor for a comprehensive pediatric eye exam provides an in-depth assessment of your child’s vision and overall eye health. With the use of innovative technology and techniques, eye exams can detect issues that can easily be missed during a vision screening.

Preparing for the Eye Exam

Come to your child’s eye exam prepared to answer a few questions about their eye habits and history of vision issues in the family, such as near or farsightedness, because our vision is partially determined by genetics.

For children old enough to understand what’s going on, it’s important to sit them down and explain what will happen. You should communicate with them about any concerns of their own they may have. Recognizing vision problems can be hard for a child, especially since it’s the only vision they’ve ever known.

Be on the lookout for some common signs of vision problems, including:

• Blurry or double vision
• Squinting
• Headaches
• Eye strain
• Turning or tilting the head/covering or closing one eye
• Strabismus (crossed eye)
• Excessive blinking
• Rubbing, tearing, itchy, or burning eyes

These aren’t the only signs of vision issues; some are easier to notice than others. Ensure your child understands that if they have any concerns, they should feel free to bring them up during the exam.

What to Expect During the Exam?

Before the Exam

Before your kid’s eye exam, the doctor may ask some general health questions like:

• Has your child shown signs of discomfort or agitation in their eyes? 
• Does your family have a history of vision conditions or eye diseases?
• Does your child have any allergies?

Following some general questions, your doctor may perform several tests to help determine if your kid has any eye conditions like nearsightedness, farsightedness, or astigmatism. 

During the Exam

During an eye exam, your child may experience one of the following tests designed to help your doctor determine if any changes have happened in your eyes.

With so many subtle signs of vision issues or eye problems, most of the time, the only way to diagnose a condition is through a comprehensive eye exam. Depending on your child’s age, their optometrist will perform a few different tests.

Infants

For babies between 6 to 9 months, the optometrist will focus on assessing their general eye health.

• Their pupil responses are tested: the eye doctor will check how your baby’s pupil opens and closes in reaction to changes in light.
• Their eye muscles are tested: the eye doctor will move an object around to see how well your baby can fixate on and follow it. The doctor will check how the eyes move and if they are coordinated.
• Their focusing ability is tested: the optometrist will check your baby’s ability to focus on near and far objects, which can indicate refractive errors.

Preschool

At this age, your child is learning and developing more and more. The world is opening up to them, and they’re preparing to enter school. It’s more important than ever to have your child’s eyes tested. Vision problems and other developmental issues can appear at this age, such as ADHD, dyslexia, and speech problems.

An exam for preschool children includes more involved tests, so it’s important to prepare your child for them ahead of time. They’ll go through many of the same tests you have in your eye exams. You might explain that the doctor will show them some pictures and ask them a few questions.

A comprehensive exam usually includes tests for:

• Visual acuity
• Eye muscle control
• Depth perception
• Hand-eye coordination
• Colour vision 

Visual acuity is normally tested by reading letters off a chart or card held some distance away. With one eye covered, your child will be asked to read out the smallest letters they can see. In some cases this may be a video monitor or images instead of letters.

Eye muscles are tested in much the same way as they were when your child was an infant: by having them follow an object around as it’s moved in front of them.

Depth perception is our eyes’ ability to produce 3D images. Your optometrist may test depth perception using special glasses and a book of test patterns.

Hand-eye coordination can be tested using a variety of assessments that require your child to follow moving objects. Finally, colour vision is usually tested using a colour plate test. Your child will be asked to view a series of coloured plates with numbers or designs.

Depending on your child’s unique needs, additional tests may also be included in their exam.

School Age

An eye exam for older children is similar to those for preschool children. It tests their visual development and focuses on detecting any eye health issues. It also includes additional tests for visual skills essential for learning and school performance. The eye doctor may ask your child questions about school to diagnose unseen vision problems.

If eye or vision problems are found at any stage, your optometrist will help you and your child determine the best treatment. Whether they need glasses or other treatment methods, early detection is crucial in maintaining your child’s eye health.

Eye Muscle Test

During an eye muscle test, the doctor will use a pen, light, or other objects to move in front of your vision while examining the movement of your eyes. It can help them to determine any muscle weakness or poor coordination.  

Visual Acuity Test

The visual acuity test is a commonly performed test using a chart with letters slowly decreasing in size. Your goal will be to identify the letters from a distance away to test the clarity of your vision.

Refraction Assessment 

A refraction assessment may involve looking at a chart and using a phoropter that changes lenses to find out which one is helping you to see better or not. The answers to your exam can help your doctor to determine the right prescription for your eyes. 

Visual Field Test

A visual field test is typically performed to find out information about your overall field of vision and if you have difficulty seeing anywhere in that field. Your doctor may elect to use one of the few variations of this test.  

Colour Vision Testing

If your doctor is worried your child may be having difficulties identifying colour, they will perform a colour vision test. A typical examination includes showing multicoloured dot patterns with numbers or letters hidden within that can be identified if you don’t have any colour vision issues. 

How Kid’s Eye Exams Change Based on Age

As kids develop and engage in new activities, their eyes will change, and symptoms or conditions may become more present. Here are a few differences you might encounter during an eye exam based on your child’s age. 

Infant Eye Exams 

An infant eye exam allows the optometrist to check for signs of misalignment or other visual conditions that can occur early on. Here are some of the tests that you might expect to see:

• Penlight exam 
• Eye movement check
• Light reaction test

Preschool-Aged Children’s Eye Exams 

As they engage in more activities, pre-school-aged children can expect more comprehensive tests during their eye exams. Some typical tests might include:

• Visual acuity test
• Lazy eye test
• Colour vision test
• Eye movement tracking
• Other ocular health issues

School-Aged Children’s Eye Exams

School-aged children are advised to book regular eye exams each year to have their eyes examined for visual issues. Some of the common things that are looked for in a typical exam include the following:

• Visual acuity 
• Eye focusing
• Eye tracking 
• Eye teaming
• Eye-hand coordination 
• Visual perception

Your Local Optometrist

Your child’s eyes constantly change through these formative years, so it’s vital to have an eye care team to help you and your child through any issues that might be discovered. Our Tonic Eye Care team is here in your community, ready to talk you through any concerns about your child’s visual health. 
Please feel free to reach out to us to schedule your child’s eye exam.