When Should Children Have Eye Exams?
According to vision experts, up to 10% of preschoolers and 25% of school-aged children have vision problems that could affect their development and learning. Even more concerning is that many of these issues can be effectively treated if caught early.
The American Optometric Association recommends the following schedule for children's eye examinations:
- First eye exam at 6 months of age
- Second eye exam at 3 years old
- Third eye exam before starting kindergarten (around age 5-6)
- Annual eye exams throughout school years
However, between these scheduled visits, it's important for parents to stay vigilant about potential signs of vision problems. Let's explore the top 10 signs that might indicate your child needs an eye exam sooner rather than later.
1. Frequent Eye Rubbing or Squinting
Does your child constantly rub their eyes, even when they're not tired? Do they squint to see objects that should be clearly visible at their distance?
Eye rubbing might indicate eye fatigue or strain from trying to focus with uncorrected vision. Similarly, squinting is a natural response to try to see more clearly. By narrowing the opening between their eyelids, children can temporarily improve their focus and clarity.
What this might mean:
- Nearsightedness (myopia) - difficulty seeing distant objects
- Farsightedness (hyperopia) - difficulty seeing close objects
- Astigmatism - blurred vision at all distances due to irregular cornea shape
If you notice your child frequently rubbing their eyes or squinting to see, it's time to schedule a comprehensive eye exam with an optometrist.
Read our blog post on common eye problems for school-age children.
2. Sitting Too Close to Screens or Holding Books Very Close
Children naturally adapt to vision challenges. If your child consistently sits unusually close to the television, holds books or digital devices inches from their face, or positions themselves at the front of the classroom to see the board, they might be compensating for a vision problem.
This behavior typically indicates nearsightedness (myopia), where distant objects appear blurry while close-up vision remains relatively clear. By bringing objects closer, they're trying to create a clearer image.
In today's digital world, it's important to note that excessive screen time can also contribute to digital eye strain, even in children with perfect vision. However, if you've established healthy screen habits and still notice this behavior, it's worth having their eyes checked.
Read our blog post about the effects of blue light on eyes.
3. Frequent Headaches or Eye Pain
Children who experience uncorrected vision problems often develop headaches from the constant strain of trying to focus. These headaches might occur:
- After school
- During or after reading
- After screen time
- When transitioning between near and far vision tasks
Headaches related to vision problems are typically located in the front of the head or around the eyes. Your child might also complain about their eyes feeling tired, burning, or hurting, especially after visual activities like reading or screen time.
These symptoms should never be dismissed as "just a headache." They could be your child's way of expressing that their visual system is under stress.
4. Covering or Closing One Eye
Have you noticed your child covering one eye when reading or watching television? This behavior often indicates that the eyes aren't working well together, a condition known as binocular vision dysfunction.
By covering one eye, children eliminate confusing visual input from the weaker or misaligned eye, making it easier to focus. This compensation strategy might temporarily improve vision but masks an underlying problem that requires professional attention.
Common conditions associated with this behavior include:
- Amblyopia (lazy eye) - reduced vision in one eye
- Strabismus - misalignment of the eyes
- Significant difference in prescription between eyes
These conditions are often treatable with early intervention, which might include glasses, vision therapy, or in some cases, medical intervention.
5. Difficulty Concentrating on Visual Tasks
If your child avoids or struggles with activities that require sustained visual attention, vision problems might be a contributing factor. This could manifest as:
- Reluctance to read or draw
- Short attention span during visual activities
- Losing place while reading
- Skipping lines or words when reading
- Using a finger to maintain place while reading
- Poor handwriting or difficulty staying within lines
Children with undetected vision problems often find visually demanding tasks extremely tiring and frustrating. Rather than struggling, they might simply avoid these activities altogether, which can be misinterpreted as behavioral issues or lack of interest.
6. Declining Academic Performance
Vision and learning are intimately connected. In fact, experts estimate that approximately 80% of what children learn in school is presented visually. If your child is having trouble seeing the board, reading textbooks, or focusing on close-up work, their academic performance may suffer despite their best efforts.
Warning signs might include:
- Sudden drop in grades
- Comments from teachers about inattentiveness
- Difficulty completing homework
- Reduced reading comprehension
- Trouble copying from the board
- Taking longer than peers to complete assignments
These challenges don't necessarily indicate a learning disability. Sometimes, the solution can be as simple as a pair of properly prescribed glasses.
7. Unusual Head Posture or Tilting
Children with certain vision problems might adopt unusual head positions to help them see more clearly. If you notice your child consistently tilting their head to one side, turning their head instead of their eyes, or raising their chin when looking at something, these could be signs of:
- Astigmatism - irregular cornea shape causing distorted vision
- Eye muscle imbalance
- Reduced vision in one eye
- Field of vision defect
By adjusting their head position, children unconsciously find the angle that provides the clearest vision or alleviates double vision. This compensatory behavior can lead to neck and shoulder discomfort over time and indicates an underlying vision issue that should be addressed.
8. Excessive Blinking, Eye Rubbing, or Discharge
Healthy eyes shouldn't draw attention to themselves. If you notice your child excessively blinking, rubbing their eyes, or having unusual eye discharge, these could be signs of:
- Eye allergies
- Dry eye syndrome
- Eye infection
- Uncorrected refractive error causing eye strain
While some of these conditions might be temporary, others could indicate more serious vision problems that require professional attention. If symptoms persist for more than a few days or are accompanied by redness, swelling, or light sensitivity, it's important to schedule an eye exam promptly.
9. Poor Hand-Eye Coordination or Depth Perception
Vision plays a crucial role in motor skill development. If your child seems unusually clumsy, frequently bumps into things, has difficulty catching or throwing objects, or struggles with activities requiring depth perception, vision might be a contributing factor.
Binocular vision—the ability of both eyes to work together—is essential for accurate depth perception and spatial awareness. Problems with eye teaming, focusing, or tracking can significantly impact a child's coordination and athletic performance.
Signs to watch for include:
- Misjudging distances
- Difficulty with stairs or curbs
- Trouble with sports involving balls
- Poor balance
- Hesitancy in new physical environments
These challenges can affect not only sports performance but also everyday activities and self-confidence. A comprehensive eye exam can identify binocular vision issues that might be contributing to coordination difficulties.
10. Light Sensitivity or Difficulty Seeing in Low Light
Does your child seem unusually bothered by bright lights? Do they have trouble adjusting when moving between different lighting conditions? Do they struggle to see in dimly lit environments?
Light sensitivity (photophobia) and poor night vision can both indicate various eye conditions that should be evaluated by an optometrist. These might include:
- Uncorrected refractive errors
- Eye inflammation
- Issues with the retina or optic nerve
- Problems with light adaptation
Children with these symptoms might avoid outdoor activities on bright days, request lights to be dimmed, or express anxiety in dark or dimly lit environments. These behaviors aren't just preferences—they could be responses to genuine visual discomfort that can be addressed with proper care.
Children's Vision at Asheville Vision and Wellness
At Asheville Vision and Wellness, we understand that examining children's eyes requires special techniques and equipment. Our eye doctors—Dr. Sid Morse, Dr. Lisa M. Greene, and Dr. Adam Greene—have extensive experience in pediatric eye care and create a comfortable, child-friendly environment for young patients.
Our comprehensive pediatric eye exams go beyond simple vision screening to evaluate:
- Visual acuity at distance and near
- Eye alignment and coordination
- Focusing abilities
- Depth perception
- Color vision
- Eye health
- Visual processing
We take the time to explain findings to both parents and children in understandable terms and develop personalized treatment plans when needed. Our goal is to ensure that vision issues don't become barriers to your child's development and success.
Early Intervention Makes a Difference
Many childhood vision problems are treatable or manageable when caught early. Interventions might include:
- Prescription eyeglasses or contact lenses
- Vision therapy for certain binocular vision disorders
- Guidance on digital device use and visual hygiene
- Strategies for the classroom and home
The key is timely detection through regular eye exams and paying attention to the warning signs we've discussed. Remember that children with untreated vision problems might not know to complain—they assume everyone sees the way they do.
Frequently Asked Questions About Children's Vision
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How can I tell if my baby has vision problems?
Watch for these signs in infants and toddlers:
Not making eye contact by 3 months
Not following moving objects with their eyes by 3-4 months
Excessive tearing, eye redness, or light sensitivity
White or grayish-white color in the pupil
Eyes that appear misaligned after 4 months of age
Excessive eye rubbing or squinting
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Will my child outgrow vision problems?
Some vision conditions, such as certain types of farsightedness, may improve as a child grows. However, most vision problems will not resolve without intervention. Conditions like amblyopia (lazy eye) actually become more difficult to treat if intervention is delayed.
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Do vision screenings at school replace the need for eye exams?
No. School vision screenings are valuable but limited. They typically only check distance vision and may miss significant issues with near vision, eye coordination, focusing ability, and eye health. A comprehensive eye exam with an optometrist is much more thorough.
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How often should children have eye exams?
The American Optometric Association recommends eye exams at 6 months, 3 years, before first grade, and annually throughout the school years. Children with existing vision conditions or risk factors may need more frequent examinations.
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Does excessive screen time cause permanent vision damage?
Current research doesn't indicate that screen use causes permanent vision damage. However, excessive screen time can contribute to digital eye strain and has been associated with an increased risk of myopia progression. We recommend following the 20-20-20 rule: every 20 minutes, look at something 20 feet away for at least 20 seconds.
Conclusion
Your child's vision is precious and plays a fundamental role in their development, learning, and overall well-being. By being aware of the signs that might indicate vision problems and scheduling regular comprehensive eye exams, you're taking essential steps to protect their visual health.
If you've noticed any of the warning signs we've discussed—from squinting and headaches to academic difficulties and coordination issues—don't wait. Contact us today to schedule a comprehensive eye exam for your child at Asheville Vision and Wellness. Our experienced doctors and friendly staff are committed to providing exceptional eye care for children of all ages in a comfortable, welcoming environment.