A Parent’s Guide to Children’s Vision: Ages 0-5

Does my child need an eye exam? Many parents are unaware that by age 5, a child should have completed three eye exams with an eye doctor. Vision screenings with a pediatrician are part of an essential health plan, but to get a complete look at how your child’s visual system is developing they need comprehensive eye exams with an eye doctor as they approach classroom learning.

“Three eye exams by age 5 are essential for early detection of treatable eye conditions like amblyopia, eye turns, clinically significant far-sightedness, and total refractive errors. These specific eye conditions can develop prior to age 5 and they have potential to hinder classroom readiness and learning as the child enters grade school. An eye doctor can get a complete look at your child’s eye health to make sure everything is developing appropriately for school success. It’s really about making sure each child can learn without difficulty from the visual system,” explains Sheryl Benjamin, Executive Director at the Colorado Optometric Association.

Recommended Comprehensive Eye Exam Schedule for Ages 0-5:

  • 6-12 Months | Comprehensive Eye Exam by Eye Doctor
  • 3 Years | Comprehensive Eye Exam by Eye Doctor
  • 5 Years | Comprehensive Eye Exam by Eye Doctor

One study by the National Eye Institute found that vision screenings miss detecting one-third of children with an eye or vision disorder. Luckily, Colorado infants, ages 6-12 months, are eligible for a no cost comprehensive eye exam with a participating InfantSEE optometrist. InfantSEE is a nationwide public health program offering early detection of potential eye and vision problems at no cost, regardless of income. Find an InfantSEE doctor today!

What to Expect at a Pediatric Comprehensive Eye Exam


Comprehensive Eye Exams for 6-12 months

It’s recommended that this eye exam takes place around the infant’s schedule picking a time when the infant is content and not fatigued. Infants usually find this exam painless and fun.

First, the caregiver will be asked to give a family history since many eye challenges are hereditary. At this age, the infant usually sits in the caregiver’s lap during the exam while the doctor engages the infant in testing. The optometrist will use handheld objects like lights and toys to check that the eyes are working properly together. The doctor may use drops or a spray to dilate the pupils and get a better look into the health of the eyes. Additional tests will be performed to look for nearsightedness, farsightedness, astigmatism, and any risk factors will be identified. The optometrist will then recommend when to schedule the next eye exam (usually at age 3 unless the infant is high risk).

Comprehensive Eye Exams for Ages 3-5
Children at this age do not need to know their letters or numbers to fully participate in the eye exam and it’s okay if they are too shy to verbalize. During this exam the optometrist will be assessing vision acuity and eye teaming while looking for clouding of the lens, refractive error, nearsightedness, farsightedness, astigmatism, lazy eye, misalignment, convergence insufficiency, focusing problems, poor depth perception, color blindness, and additional eye health issues.

Tell your eye doctor if your child has/had any of the following issues:

  • Born premature
  • Delayed motor development
  • Repeated eye rubbing
  • Excessive blinking
  • Fails to maintain eye contact
  • Poor eye tracking

Find a Local Optometrist Today!

6 Impactful Ways to Age-Proof Your Eyesight

Age proofing your eyesight is a continuous process that is best when started early in life, but can be implemented at any age for eye health benefits. The rate in which our eyes age can be reduced if we are mindful of what increases age-related eye diseases and what slows the eye-aging process. For instance, once UVA/UVB damage to the eye occurs it’s often not reversible.

The likelihood of good vision throughout the lifespan is increased by practicing these six areas of protection as early as possible; good nutrition, exercise, sun protection, avoid smoking, limit drinking, and get annual comprehensive eye exams with your local optometrist.

Dr. Tom Cruse, Colorado Optometric Association’s Board President says, “The more annual comprehensive eye exams that you can attend as you age translates to having a much higher chance of early detection and can equate to avoiding issues later in life that include low vision issues, blindness or even save your life. Live that healthy lifestyle and see your optometrist regularly for the best chance at age proofing your eyesight.”

  • Annual Comprehensive Eye Exams: It’s simple, just because you don’t have any symptoms does NOT mean you should skip your annual comprehensive eye exam. Many vision threatening eye diseases such as glaucoma, macular degeneration, cataracts, or diabetic retinopathy have no or minimal symptoms until the disease has progressed. Early detection is key to slowing progress, managing disease, and saving vision. Optometrists look at a lot more than just your visual acuity in a comprehensive exam and can even detect other health issues such as autoimmune conditions, allergies, medication complications, high blood pressure, high cholesterol, diabetes and more. Find a trusted Colorado optometrist here!
  • Good Nutrition: When choosing what to eat throughout your day make sure you’re getting the nutrients that promote healthy eyes. To support your eye health and reduce eye disease risks choose foods rich in vitamins C and E, zinc, lutein, zeaxanthin, and omega-3 fatty acids DHA and EPA. If you have already been diagnosed with an eye disease check with your optometrist to understand which foods can support your eye health and which foods can provoke your symptoms or even speed up the progression of the disease. Your eye doctor may even prescribe a nutritional supplement to support your eye health. More nutritional information. 
  • Regular Exercise: Regular exercise is helpful across the board for your general health, but it’s also essential for keeping your vision from diminishing. One study of more than 15,000 people discovered that individuals who exercised and drank occasionally had less vision loss over a 20-year period than individuals who did not exercise and did not drink.1 This finding outlines the importance of exercise. Find the exercise that works for you whether it’s walking, hiking, running, swimming, weightlifting, or the countless other ways to get movement in.
  • Consistent Sun Protection: Sun exposure can increase your risk of cataracts and if you have blue eyes and fair skin your risk of cataracts is even higher. Once sun damage of the eye occurs, the long-term impact is not reversible making sunglasses more important than most people think. The Colorado sun is bright due to the elevation and the intense sun reflecting off of snow or water. Grab a pair of 100% UVA/UVB blocking sunglasses to safeguard your eye health and wear them when outside. Pair your sunglasses with a hat for even more UV protection since sunlight can slip in through the side of your glasses. Start your kids off right by protecting their eyes early on. Bonus, tiny sunglasses are cute!
  • Continue to Avoid Smoking or Quit Smoking If You’ve Started: The truth is that smoking tobacco increases the risk of age-related macular degeneration (ARMD), cataracts, glaucoma, diabetic retinopathy and dry eye syndrome. Many of these diseases can lead to vision loss or blindness. ARMD is the leading cause of blindness and studies show that smokers have up to four times the risk of developing ARMD. If you’ve been unsuccessful at smoking cessation keep trying and get support such as using the Colorado QuitLine, a free support program for Colorado residents. Call 1-800-QUIT-NOW or Enroll today. 
  • Limit Alcohol Intake: It’s common knowledge that alcohol can impact your vision during use. The long-term effects of alcohol consumption can include increased risk of cataracts, age-related macular degeneration, and optic neuropathy. Heavy drinking can impact your body’s ability to absorb vitamins and nutrients, which are needed for proper eye health.

The Sobering Risks of Skipping That Annual Eye Exam

Many people don’t realize that in addition to keeping your eyes healthy and addressing eye health challenges, optometrists can detect over 270 serious health conditions before symptoms ever occur.

That’s because the eye is the only place in the body where a doctor can look at blood vessels and understand the health of an individual’s eyes and body. This deep look into a patient’s health is performed by optometrists in every annual comprehensive eye exam. If you’re avoiding this annual examination, then you’re missing out on a full picture of your health and an opportunity for early identification.

The 270+ health conditions that eye doctors can detect include:

  • certain cancers
  • autoimmune diseases
  • diabetes
  • hypertension
  • high cholesterol
  • hormonal imbalances
  • brain tumors
  • many more conditions

In 2014, the American Optometric Association performed a study that found optometrists had detected over 250,000 diabetes-related manifestations that led to a diabetes diagnosis in patients who were unaware of their health condition.1

“Nobody wants to have a health issue, but Colorado optometrists are equipped and can detect both eye-related and general health conditions before symptoms ever occur. That can give any patient a better outcome and management plan than if the condition went unidentified. Optometrists provide an essential opportunity for early identification that can lead to saving vision and saving lives,” says Dr. Tom Cruse, Board President for the Colorado Optometric Association.

These conditions can only be detected by your eye doctor in a comprehensive eye exam and not in vision screenings or online exams. Colorado optometrists agree that there isn’t a replacement or hack to comprehensive eye exams. The great news is that the exam only takes about 30-60 minutes to get that detailed picture of your vision and health. 

Studies show that lack of symptoms, cost of eye care, lack of insurance and/or lack of transportation as the most common barriers to treatment in patients 40 years and older. Other individuals assume that nothing can be done to improve their vision, which is a bold misconception as new technology is introduced regularly.

‘No symptoms’ is not an excuse! Colorado doctors of optometry want to be very clear that one of the best times to have an exam is before symptoms become known. This means that if any eye health or general health issue is detected it can be possible to treat and/or manage the issue before irreversible damage occurs to the body or eyes.

The American Optometric Association has noted, “58% of asymptomatic patients presenting for a routine comprehensive eye exam had either a change in ocular status or care-management plan, as compared to 77% of symptomatic routine eye exam patients.”2

Many eye diseases and health issues that an eye doctor can detect through a comprehensive eye exam are correctable or manageable with early detection. The financial impact and prominence of eye health issues can be reduced through early detection during an annual comprehensive exam. The sooner you know you have the health issue, the sooner you can address it and prevent progression of the condition.

What Can I Expect at a Comprehensive Eye Exam?

A comprehensive eye exam usually takes 30-60 minutes and is performed by an optometrist or ophthalmologist. The exam covers 12 areas of observation and testing, whereas screenings only check one area: vision acuity.  

The following do NOT count as a comprehensive eye exam:

  • Eye screenings are not comprehensive (including the eye screening at the DMV)
  • Online eye exams are not comprehensive
  • App-based vision tests are not comprehensive

Comprehensive Eye Exams Include:

Patient History
The doctor or staff will collect information on your health, family, and vision history along with current medications and symptoms. They will clarify your chief concerns.

Visual Acuity Testing
Testing for your vision with and without correction or with glasses or contact lenses.

Preliminary Tests
Testing eye pressures, screening for side vision, color vision, stereo acuity, pupil reactions, eye teaming and tracking.

Keratometry/Topography
Measuring the shape of the cornea.

Refraction
Checking the power of the glasses needed.

Eye Focusing, Eye Teaming, and Eye Movement Testing
Looking at how the eyes work together during focusing and movement.

Eye Health Evaluation
Evaluating the health of the front of the eye and inside the eye.

Supplemental testing
Depending on the findings of your exam the doctor may order further testing. This could include, but is not limited to: digital imaging of the retina, visual field testing, OCT, meibomography, photodocumentation.  This testing is used to further clarify the diagnosis and treatment plans for such disease as: glaucoma, macular degeneration, dry eye, visual efficiency issues or the need for contact lenses.

Many of these serious health and eye health conditions can be threats to an individual’s vision, life, or quality of life when left undetected. Get a clear picture of your health by finding a trusted optometrist here.

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