Eye exams and tests for children and teens
The American Academy of Pediatrics (AAP) and the American Academy of Ophthalmologists (AAO) recommend that all children have an eye exam during the newborn period and again at all routine well-child visits.1
The U.S. Preventive Screening Task Force (USPSTF) recommends screening (tests) to detect lazy eye (amblyopia), misaligned eyes (strabismus), and defects in visual acuity in children younger than 5 years of age.2
The AAP recommends that vision screening start around age 3 and occur each year at ages 4, 5, and 6. After that, screening should occur at ages 8, 10, 12, 15, and 18.3
The AAO recommends that vision screening start around age 3 and occur each year at ages 4 and 5. After age 5, the AAO recommends screening every other year.4
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. The first screening is recommended between 4 and 7 weeks after birth.5 Any infant with symptoms of eye disease, such as redness or swelling, should be examined by an eye doctor (specialist) as soon as possible.
- A family history of eye problems, especially genetic eye diseases.
- Signs of misaligned eyes, lazy eye, or nearsightedness.
- A red, swollen, or cloudy eye.
Children who have refractive errors or have a disease that affects the eyes
Children and teens with a disease that affects the eyes can follow the eye exam and vision testing schedule for all children. It's best that they see an eye doctor (specialist) for their eye care.
At least once a year, most eye doctors want to check the vision of children and teens that have refractive errors that impact their sight. If nearsightedness is severe or quickly gets worse in a child, he or she will need exams more often.
- 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.
- 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.
- American Academy of Pediatrics (2008). Recommendations for preventive pediatric health care. In Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd ed., p. 591. Elk Grove Village, IL: American Academy of Pediatrics. Also available online: http://practice.aap.org/content.aspx?aid=1599&nodeID=4003.
- American Academy of Ophthalmology Pediatric Ophthalmology/Strabismus Panel (1992, revised 2007). Pediatric eye evaluations: I. Screening. II. Comprehensive ophthalmic evaluation. National Guideline Clearinghouse. Available online: http://www.ngc.org/summary/summary.aspx?doc_id=11753&nbr=006057&string=.
- 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.]
Last Updated: July 6, 2009
Author: Debby Golonka, MPH
Medical Review: Adam Husney, MD - Family Medicine