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Home » Articles by Urban Opticians » Children’s eye exams and why are they important By Dr. M. Jafferji

Children’s eye exams and why are they important By Dr. M. Jafferji

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Learning is how children grow.  We learn using all our 5 senses: touch, sight, hearing, smell and taste.  By far, sight is one of the most important senses when it comes to learning and growth.  Proper functioning of a child’s visual system is critical in optimal learning. We always advise parents to get their child’s eye exam because vision problems can interfere with school performance and potentially affect child’s safety. It is a common mistake to wait for a child to show signs of some sort of visual impairment because in most cases it is not easily evident.  Children do not complain right away because the quality of their vision becomes normalized and there are circumstances where only one eye is seeing and compensating for the other. Time is of the essence when it comes to visual perception and development. The sooner the problem is detected in children the better the prognosis will be when treating conditions, especially lazy eyes.

By six months of age, a child’s visual acuity is around 20/100 which is still poor.  Children don’t reach adult levels of visual acuity until they are age 4 to 6. According to College of Optometrists of Ontario, it is recommended to bring a child for their first eye exam as early as 6 months old and then before school starts at 4 years of age.  Therefore, annual eye exams are recommended as children vision can change over time as they grow in their environments.

There are 4 main visual skills children require for accurate visual perception and processing during learning. Early eye exams are important so any deficiencies in these skills can be detected and addressed.

  1. Excellent visual acuity at all distances
  2. Accurate and comfortable eye teaming skills
  3. Accurate eye movement skills
  4. Accurate and comfortable focusing skills

Having good visual acuity at all distances is paramount for learning because that’s how we see things as being clear which makes processing of information more efficient.  Having poor visual acuity can cause mental block and frustration which can possibly lead to mental health concerns as well. Once measured, the good news is that visual acuity can easily be improved with the use of corrective lenses. It is also common to see children with good visual acuity in one eye and not the other. This imbalance in visual acuity can lead to a lazy eye or amblyopia.  Amblyopia is when one eye’ visual acuity is subpar or less than 20/40 vision even with corrective lenses. A child can develop amblyopia either when there is significant disparity in visual acuity between the eyes or when the two eyes are not working as a team.

Adequate eye teaming skills are also essential for optimal learning.  In order for us to see binocularly our two eyes have to be pointing at the same thing at the same time. When two eyes don’t work as a team it can cause double vision, shadows, confusion and perhaps headaches as one eye has to compensate for the other.  We also require adequate eye teaming skills to be able to appreciate perception of depth i.e. stereopsis or 3 dimensional structures. Vision therapy/exercises can be administered to help improve eye teaming skills and depth of perception in children by way of strengthening binocularity. Prism lenses can also be utilized in some cases to help with eye teaming.

Accurate eye movements are also essential in acquiring, fixating and tracking visual stimuli for example when following word by word while reading a book up close or from a smart board in class. As children we learn different types of voluntary eye movements to help us with reading efficiency and following instructions. There are exercises that are available also to train and improve children eye movements if need be.

In order to see and keep objects clear at all times and at all distances, a child’s focusing skill need to be accurate.  The ability to adjust the optics of the eye to keep things in focus is called accommodation. When a child is far sighted the accommodative stress on the visual system with time when looking up-close can cause visual fatigue and possible headaches.  Fortunately, focusing skills can easily be improved with eyeglasses and eye exercises.

Annual exams in children also ensures that the anterior and posterior segments of their eyes are healthy as well.  Even though rare, there are several acute retinal conditions, which may a child may not be symptomatic but can be vision threatening if undetected, such as retinal holes, tears, detachments, certain types of glaucoma, and corneal conditions such a Keratoconus, which children can develop from chronic rubbing of eyes.  Only regular eye exams from a qualified optometrist can detect some of these conditions.