Peadiatric eye examination

By Mardeen Tait - (UFS) CAS(SA)

Why is an early vision screening so important?

Good vision is key to a child’s physical development, success at school, and overall well-being. The vision system is not fully formed in babies and young children, and equal input from both eyes is necessary for the brain’s vision centres to develop normally. If a young child’s eyes cannot send clear images to the brain, vision may become limited in ways that cannot be corrected later in life.

If problems are detected early, it is usually possible to treat them effectively. It is essential to check children’s vision when they are first born, again during infancy, preschool and school years. 

Visual acuity should be tested as soon as the child is old enough to cooperate during an eye examination. This is performed during pre-school years if no other eye problems were detected earlier on. Upon entering school, or whenever a problem is suspected, children’s eyes should be screened for visual acuity and ocular alignment by an optometrist.

A comprehensive eye examination is necessary in the early years when:

  • A child fails a vision screening.

  • Vision screening is inconclusive or cannot be performed.

  • Referred by a paediatrician or school nurse.

  • The child has a vision complaint or observed abnormal visual behaviour or when a family history of an eye condition is present.

  • The child has a learning disability, developmental delay, neuro-psychological condition or behavioural issue.

A comprehensive eye examination will include the child’s vision, ocular muscle balance, ocular alignment, and focussing ability (accommodation), vergence testing to see if the eyes works together by moving in and out, colour vision, and depth perception/stereopsis testing to determine the child’s spatial orientation. An objective refraction can be done in the very young and where applicable a subjective refraction.