Eye exams for children and teens

Use the guidelines below to schedule routine vision checks and eye exams with an ophthalmologist or optometrist.

The U.S. Preventive Screening Task Force (USPSTF) recommends screening to detect amblyopia, strabismus, and defects in visual acuity in children younger than 5 years of age.¹ For preschoolers with no vision problems and no family history of childhood eye problems:¹

• Many experts recommend that children have their vision tested between the ages of 3 and 5 years.
• Children who have no vision problems and no family history of childhood eye problems may have their eyes tested during a routine medical visit or at school.
• If there is a family history of childhood eye problems, a vision exam should be done by an eye doctor.

Infants and children younger than age 3 usually do not have significant vision problems that involve refractive errors. Even so, the American Academy of Pediatrics and the American Academy of Ophthalmologists recommend that all children be tested for eye problems during the newborn period and again at all routine well-child visits.² In particular, vision screening is recommended for infants who were either born at or before 30 weeks, whose birth weight was less than 1500 g (3.3 lb), or who have serious medical conditions.³

Infants with symptoms of eye disease, such as redness or swelling, should be examined by a specialist as soon as possible.

Eye exams by a specialist are also recommended before age 3 years if:

• The family has a history of childhood eye problems, especially genetic eye diseases.
• Signs of misaligned eyes (strabismus), lazy eye (amblyopia), or nearsightedness (myopia) are present.
• The child's eye is red, swollen, or cloudy.

School-age children and teens with no vision problems should have their vision checked every 18 to 24 months.

Children and teens with a disease that affects the eyes should have their vision checked every 18 to 24 months.

Children and teens with nearsightedness or other refractive errors should have their vision checked at least once a year. Children with severe or rapidly worsening nearsightedness will need exams more often.

Citations

1. U.S. Preventive Services Task Force (2004). Screening for visual impairment in children younger than age 5 years: Recommendation statement. Rockville, MD: Agency for Healthcare Research and Quality. Available online: http://www.ahrq.gov/clinic/uspstf/uspsvsch.htm.

2. American Academy of Pediatrics et al. (2003). Policy statement: Eye examinations in infants, children, and young adults by pediatricians. Pediatrics, 111(4): 902–907.

3. American Academy of Pediatrics Section on Ophthalmology, et al. (2006). Screening examination of premature infants for retinopathy of prematurity. Pediatrics, 117(2): 572–576. Also available online: http://aappolicy.aappublications.org/cgi/reprint/pediatrics;117/2/572.pdf. [Erratum in Pediatrics, 118(3): 1324. Also available online: http://aappolicy.aappublications.org/cgi/reprint/pediatrics;118/3/1324-a.pdf.]