Eye exams recommended to preserve children’s vision

By Robert N. Kang
U.S. Army Public Health Command

According to the National Eye Institute, vision disorders are the most common handicapping conditions during childhood in the United States. Yet, fewer than 15 percent of all preschool children receive eye examinations.

Studies have shown that preschool vision screenings reduce vision disorders among school-age children.

Many primary care and pediatric clinics, and schools provide vision screenings to identify children who will benefit from comprehensive eye examinations.

But how effective are these screenings in identifying those children? As a parent, can you trust the vision screening or should you take your preschooler for an eye examination, regardless?

A large clinical study on preschoolers conducted by the NEI found that specially trained nurses and lay people were as effective in vision screenings as licensed eye care professionals.

Importantly, however, the results depended on the specific tests and equipment used, as well as the specific vision condition being tested.

This study clearly showed the value of vision screenings when properly done, but also showed some of its limitations.

So, what should a parent do?

Parents should ask which vision problems are being assessed in the screenings and ask about the accuracy of the tests, according to the NEI study chairperson, Paulette Schmidt.

The American Optometric Association recommends eye examinations for infants and children at six months and 3 years of age.

For school-age children, eye examinations are recommended before first grade and every two years thereafter.

Of course, an infant at higher risk, from family history for example, should have an examination as soon as medically practicable. Similarly, children with symptoms or higher risks should also be examined more frequently.

It is estimated that up to five percent of 3 to 5 year olds have amblyopia or “lazy eye,” and about four percent have strabismus or “squint” where one of the eyes is not aligned straight with the other eye.
Also, 10-15 percent of children have significant refractive errors needing correction with eye glasses.

Overall, 15 percent of children have an eye or vision problem that if not corrected, can result in reduced vision.

Yes, vision screenings may be valuable in identifying children with potential eye and vision problems, but until more accurate and effective screening tests and equipment become available, eye examinations during the early years of any child’s development are a must.

Editor’s Note: The author, Robert N. Kang, is an optometrist.