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Vision Exams Recommended for Children Going Back to School

September 2, 2009

It’s back to school time. Did you know, vision problems affect one in 20 preschoolers and one in four school-age children? Untreated eye problems can worsen and lead to other serious problems as well as affect learning ability, personality and adjustment at school.

The American Academy of Ophthalmology recommends timely vision and eye health screening for the detection and early treatment of eye problems in America‘s children. This includes institution of vision screening during the preschool years. Screening by lay people mainly detects reduced vision in one or both eyes from errors of refraction, amblyopia, and strabismus. Other eye health screening is carried out during infancy, and depends in large part on parental awareness as well as on detection of eye disease by primary care physicians. Very early detection of treatable eyes disease in infancy and childhood can have far reaching implications for vision and, in some cases, for general health.


The American Academy of Ophthalmology recommends that infants and children be screened as follows:

  1. A pediatrician or family physician should examine a newborn’s eyes for general eye health in the nursery. An ophthalmologist should be asked to examine all high risk infants, i.e., those at risk to develop retinopathy of prematurity (ROP), those with a family history of retinoblastoma, congenital glaucoma, cataracts, or diseases associated with eye problems, or when any opacity of the ocular media or nystagmus (purposeless rhythmic movement of the eyes) is seen. Examination of those infants should be repeated at appropriate intervals. No infant is too young for an eye examination by an ophthalmologist. An ophthalmological examination should be performed whenever questions arise about the eye health of a child at any age.
  2. All infants by six months of age should be screened for ocular health by a pediatrician, family physician or an ophthalmologist.
  3. Each child at age approximately 3 ½ should be screened for eye health by a pediatrician, family physician, or an ophthalmologist. Emphasis should be placed on testing of visual acuity.
  4. Children at age 5 years should have vision evaluated and alignment assessed by a pediatrician, family physician, or an ophthalmologist. Those children who fail either test should be examined by an ophthalmologist.
  5. Further screening examinations should be done at routine school checks or after the appearance of symptoms. Routine professional eye examination of the normal child has no medical benefit.

Most serious ocular conditions, which can be found at screening and are treatable, are identified in the preschool years. Many of these conditions are associated with a positive family history. Screening emphasis should, therefore, be directed to at risk infants and to those children in the early preschool years.

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