Eye exams for children and infants

The U.S. Preventive Screening Task Force recommends screening to detect amblyopia, strabismus, and other vision problems in children younger than age 5 years.¹ Children who do not have signs of vision problems and who have no family history of childhood eye problems may have their eyes tested during a routine doctor visit. Children from families with a history of childhood eye problems need to have their vision tested by an eye care specialist (an ophthalmologist or optometrist).

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.

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, reaffirmed 2007). Policy statement: Eye examination 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. [Errata in Pediatrics, 117(4): 1468 and Pediatrics, 118(3): 1324.]