Did you know that vision screening should be performed starting in the first few hours of your child’s life and continue to be performed periodically until he/she is about 8 years old? The first vision screening takes place in the nursery when the pediatrician inspects the newborn’s eye, pupil and red reflex. The child’s pediatrician continues to perform age appropriate vision screenings through infancy and childhood in addition to vision screening that is offered at day care, school or church.
Vision screening is designed as an efficient and cost-effective method to identify children with visual impairment or eye conditions that are likely to lead to visual impairment so that a referral can be made to an appropriate eye care professional for further evaluation and treatment. Methods for visual screening in pre-verbal children include pupil testing, red reflex, photoscreening, corneal light reflex testing, and cover testing. Subjective visual acuity testing is the “gold standard” for vision screening but requires a verbal and cooperative child. Successful visual acuity testing is greatest with children 3 years and older. The State of Utah requires vision screening to be performed on each child under the age of 8 who is starting school.
When should a child have a comprehensive eye exam with a dedicated eye doctor? The American Association for Pediatric Ophthalmology and Strabismus does not recommend comprehensive eye exams for all children. They argue that only about 2 to 4% of children have an eye problem that requires treatment, so it is not practical to perform a comprehensive eye exam on every child. However, the American Optometric Association recommends that every child have their first comprehensive eye exam between the age of 6 to 12 months. In any case, if a child has a known risk factor for eye disease, if there is a family history of pediatric eye disease, or if a child has signs or symptoms suspicious for a vision problem, it is reasonable and appropriate for a child to have a comprehensive eye examination.