At what age should a child have the first visual exam?

80% of the information that we receive at the brain level, comes to us through the eyes, hence the importance of the early detection of possible visual alterations to be able to treat them, since the more time passes from the detection of the problem until we address it, the worse prognosis the treatment will have. Child or pediatric optometry is the one that cares for patients from birth to adolescence, and treats any type of visual dysfunction through re-education of the binocular system, contact lenses, glasses, visual therapy, visual hygiene guidelines, among others, with the aim to prevent any alteration in the child’s visual system from causing alterations during motor development, learning problems and/or school failure.

Regular check-ups from newborns

The critical age for the child’s visual development is between birth and 2 years, which is when the visual system is in full development and is evolving towards a state where there is no type of refractive error or graduation (known as emmetropia) that can harm the patient such as myopia, hyperopia, and astigmatism. In this phase, prevention and early detection are especially important to try to solve the problem as soon as possible.

So, when is it convenient to have a visual exam on a child? Pediatric eye health professionals advise regular checkups at the following ages:

• Newborns
• 6 months
• 9 months
• 15 months
• 2 years
• From 2 years old every year

In the check-ups that we carry out on children while they are babies, we do not need to obtain the exact graduation of their eyes, but rather it is intended to rule out the presence of any problem that may generate a lazy eye, strabismus, or a refractive defect. This is a very general check-up to check that the visual system is developing in an adequate way and it is not necessary for the child to speak to be able to carry out the visual examination.

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One of the tests that we use to assess vision in children up to 15 months is cards, in which there are some stimuli and others in which there are not. The baby will tend to look at the background where there is contrast, so when presenting the two pictures to him, if the child does not present any visual problems, he will direct his gaze to the picture with stimuli. Another type of test is to assess the reflex that your eye produces (retinoscopy) to rule out myopia, hyperopia, or astigmatism, or the presence of some opacity that prevents you from developing your vision correctly.

What can I look at to see if my child sees or does not see well?

Parents can observe if from 3-4 months the child follows them with their eyes or follows toys, or if, on the contrary, they have inattention. They can also see if the child has a deviation of one or both eyes (which is known as strabismus), or the presence of a white spot in the pupil area is another sign that can warn them of a vision problem.

As the child grows, there will be more details in the day to day that will give you information about her/his vision, such as how the child walks, if he trips easily, how he plays, how he climbs the stairs, or if is able to distinguish people or objects that are at a long distance.

Counting on the advice of a visual health professional such as the optometrist is essential to detect visual dysfunctions that impede the correct visual development of children from a very early age.