Protect Your Peepers!

Preschool Eye Exam Basics

Did you know that children between 2 and 5 years of age should have at least one comprehensive eye exam?

It is recommended that preschool children have a comprehensive eye exam around three years of age and another eye exam before they start kindergarten. If your preschooler requires glasses or there is a family history of vision issues, it is recommended that they visit an optometrist annually.

Preschoolers are still fine-tuning their visual skills and it is imperative that any vision issues be caught before they cause long-lasting damage to their vision or impede other areas of development. Eye exams are important at this age because children's development and learning are directly connected to the following skills associated with good eyesight:

• near vision
• distance vision
• binocular (two eyes) coordination
• eye movement skills
• focusing skills
• peripheral awareness
• hand-eye coordination

What to Expect During the Exam

Come prepared to share your child's birth history, medical history and family history. Prepare your child beforehand by explaining that the optometrist will be looking at their eyes--never surprise them with a visit, give plenty of warning so they are comfortable having their eyes examined. Choose a time that works best for your child (ex. avoiding naptime or the end of a busy day) to provide the best opportunity for a successful visit. 

Common Eye Tests Used for Young Children:

• LEA Symbols: an eye chart for young children between 3 and 6 years of age who cannot yet read that uses symbols or shapes (ex. apple, house, square, circle) 
  

• Retinoscopy: a test that shines light into the child's eye to observe the reflection from the back of the eye (retina) which helps determine a child's eye glass prescription

• Random dot stereopsis: uses special patterns of dots and 3-D glasses to measure how well your child's eyes work together
  

• Tumbling E Chart: all characters on the chart are a capital letter "E," in different spatial orientations (rotated in increments of 90 degrees) and the optometrists will ask the child to use either hand (with their fingers extended) to show which direction the "fingers" of the E are pointing: right, left, up or down
  

Warning Signs

If your Preschooler is struggling with any of the following symptoms, book a comprehensive eye exam as soon as possible:

• red, itchy or watering eyes
• sensitivity to light
• an eye that consistently turns in or out
• tilting their head to see better
• squinting, rubbing the eyes, or excessive blinking
• a lack of concentration
• covering or closing one eye
• irritability or short attention span
• holding objects too close
• avoiding activities that require near vision, such as reading or coloring, or distance vision, such as playing ball or tag
• visible frustration or grimacing
• complaining of headaches or tired eyes

FYiDoctors provides information for each province regarding coverage for eye exams. BC MSP covers ONE full eye examination yearly for children birth to 18 years.

Resources

All About Vision

Canadian Association of Optometrists

Canadian Pediatric Society

Canadian Doctors of Optometry

Eye Glass Guide

Protect Your Peepers!

Infant Eye Exam Basics

Did you know infants should have their first comprehensive eye exam by 6 months?

Why so young you ask? Vision development is a crucial part of your baby’s overall development. It affects areas such as fine and gross motor skills, cognitive and language development and even your baby's emotional development.

At six months, it is easier for an Optometrist to assess your child’s development and determine if a vision issue may be present because developmental milestones are more obvious during this stage of growth and learning. Early intervention at this age lessens damage that could lead to lifelong vision issues.

Infant Eye Exams

During an infant eye exam an Optometrist will be checking the health of your baby's eyes and looking for anything that might interfere with normal and continuing vision development. This includes looking at:

• Age appropriate Visual Acuity
• Refractive Status
• Eye Movement (eye motility)
• Eye Alignment/Binocular Potential (eye teaming)
• Visual Integration/Hand-Eye Coordination
• Eye Health

Be prepared to answer questions about your child's birth, health history and family history. During the eye exam you will be asked to hold your baby while the optometrist examines their eyes--be prepared to participate in activities or games that help the optometrist get a thorough look at your baby's vision skills.

Vision Skills Your Baby Is Developing

In the first six months, infant eyes are developing the ability to:

• work together
• focus clearly at different distances quickly, accurately, and for sustained periods of time
• smoothly follow moving objects and to move accurately from one object to another.

At Birth:

• your baby sees only in black and white and shades of gray
• a newborn infant's eyes don't  yet have the ability to accommodate or focus on near objects

During the First Month:

• one week after birth, they can see red, orange, yellow and green
• it takes a little longer for them to be able to see blue and violet
• it is normal for your baby's eyes to sometimes appear to not be working together as a team yet. For example, one eye may occasionally drift inward or outward from proper alignment

At 2-3 Months:

• develop sharper visual acuity during this period, and their eyes are beginning to move better as a team
• learning how to shift their gaze from one object to another without having to move their head

4-6 months:

• see more distinctly and are developing depth perception 
• move their eyes quicker and more accurately to follow moving objects

• Visual acuity improves from about 20/400 at birth to approximately 20/25 at 6 months of age
• Color vision should be similar to that of an adult by six months

7-12 months:

• infants become mobile and begin learning how to coordinate their vision with their body movements

• infant's eyes also begin to change color during this time

You can help your baby's vision development with simple games and activities.

What to Watch for...

Eye alignment problems

It takes a few months for an infant's eyes to develop eye teaming skills. However, if you feel one of your baby's eyes is misaligned constantly or does not move in synch with the other eye, contact your family doctor or optometrist as soon as possible.

Some terms you may hear from your Optometrist:

Amblyopia or lazy eye

Astigmatism 

Hyperopia or farsightedness

Myopia or nearsightedness

Strabismus 

Premature Infants

Premature babies have a greater risk of developing eye problems than full-term babies so it is extremely important for them to have a comprehensive eye exam at 6 months. Two of the main vision concerns with a premature baby are:

Retinopathy of prematurity (ROP): the abnormal replacement of normal tissue in the retina with fibrous tissue and blood vessels. ROP can cause scarring of the retina, poor vision, retinal detachment and even blindness. All premature babies are at risk of ROP.

Nystagmus: the involuntary, back-and-forth movement of both eyes which usually causes the eyes to drift slowly in one direction and then "jump" back in the other direction. The eye movements are usually horizontal, but they can be diagonal or rotational as well. It can be present at birth, or it may develop weeks to months later.

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Resources:

All About Vision

InfantSEE

Doctors of Optometry Canada

American Optometric Association