Healthy eyes and vision are a critical part of a child's development. They need good vision to identify objects and master the basics of moving around. Their eyes should be examined regularly, as many vision problems and eye diseases can be detected and treated early. If you are a parent of a toddler or a preschooler, you may often wonder if your child has a vision problem. There is no doubt that eye exams for children are extremely important. According to the All About Vision website, 25% of school aged children have vision problems. This means that early detection of problems can be critical at this early age and require diagnosis. 

When is the first eye exam needed?

During infancy, a child's vision is constantly changing. In the earliest months of their lives, babies can only focus on close-up objects, and they see only high contrast colors, such as black, white and red. At six months of age, however, visual acuity sharpens. It is at this point that babies should have their vision examined by an eye doctor to ensure that their eyes perform as a team, working together. If not, one of both eyes may be affected and that could lead to a lifetime of poor vision. 

From this point on during childhood development, eye exams should become an annual ritual, just like annual check-ups at the pediatrician's office. 

For children between the ages of 3 and 5, the eye doctor will conduct a physical eye exam of the eyes and also do vision screenings using eye chart tests, pictures, letters, or the "tumbling E game", which tests that child's visual acuity, or ability to see form and detail of objects. The "tumbling E game", also called the Random E's Visual Acuity Text is useful in determining the eyesight of children who cannot yet read. The child is asked to identify the direction that the letter "E" opens to by holding out three or four fingers to mimic the letter "E". You can practice this test at home before your appointment. 

What can be detected during an eye exam?

Children's eye exams can identify nearsightedness, farsightedness, and astigmatism, conditions that can be easily remedied with prescription glasses. But an eye exam can also detect amblyopia (lazy eye) and strabismus. Strabismus is a condition in which the eyes don't look together in unison at the same object. Strabismus is a physical disorder; amblyopia is the visual consequence. Amblyopia and strabismus are most effectively treated when detected early. Treatment includes visual therapy and, often, surgery. Left undetected or untreated, blurry or double-vision may be a lasting result. 

The good news is most childhood eye conditions can be corrected or effectively treated - especially if they are caught early. And by far the best way to identify and diagnose these problems is through a comprehensive eye exam. Unfortunately many children who should be getting eye exams aren't receiving them. 

When should children have eye exams?

The AOA recommends that children have a comprehensive eye exam every two years. More specifically: 

• First 12 months - Infants, particularly premature babies, should have an eye exam in the first 12 months. 
• Age 2 or 3 years - Preschool is a critical time for learning. Preschoolers should have an eye exam when they are old enough to understand and respond to an exam. 
• Age 5 - Kindergarten is also a critical time for learning. Kindergarteners should have an eye exam before entering school. 
• Children without identified vision problems should then have a comprehensive eye exam every two years. 
• Children who wear glasses or who have other eye conditions should see the eye doctor at least annually, or more often, as recommended by their doctor.