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Children's Eye Exams

Children's Eye Exams in Phoenix

The single most useful thing a parent can know is that a child who passed the school screening may still have a vision problem that is making school harder. Screenings test distance acuity, which is one narrow slice of visual function, and the problems that interfere with reading are usually elsewhere.

A child can have perfect distance vision and be unable to sustain focus at reading distance for more than a few minutes, or have eyes that do not converge properly, so text doubles or swims after a page. Neither shows on a chart. Both look, from the outside, like a child who does not want to read.

Children also almost never complain, because they have no basis for comparison. Whatever they see is simply what seeing is. This is why so many vision problems are found by a teacher rather than reported by the child.

When children should be examined

Around six months
The first exam. We assess eye health, check for significant refractive error, and confirm the eyes are aligned and developing normally. Conditions found this early are the most treatable they will ever be.
Around age three
Assessment of visual development, alignment and refractive error, using age-appropriate testing that does not require reading.
Before starting school
Important because so much of early education is visually demanding. Problems found now are corrected before they turn into a reading difficulty and a confidence problem.
Annually thereafter
Vision changes as children grow, and the years between seven and twelve are when myopia typically appears and progresses fastest.

Signs that warrant an exam now

  • Sitting very close to screens or holding books unusually close
  • Squinting, tilting or turning the head to see
  • Covering or closing one eye to read or watch
  • Frequent eye rubbing that is not obviously allergy
  • Complaints of headaches, particularly after school or homework
  • Losing place while reading, skipping lines, or using a finger long past the usual age
  • Short attention span for near work specifically, while attention for other activities is fine
  • Avoiding reading, or reading well below the level the child manages when read to
  • An eye that turns in or out, even occasionally or only when tired
  • Poor hand-eye coordination or unusual clumsiness

What we test beyond the chart

Focusing (accommodation)
The ability to shift focus between distances and sustain focus at near. Accommodative dysfunction makes reading exhausting while leaving distance vision perfect.
Eye teaming (binocular vision)
Whether both eyes point at the same place and work as a pair. Convergence insufficiency is common, very treatable, and invisible to a screening.
Eye tracking
Smooth, accurate movement across a line of text. Poor tracking produces skipped lines and lost place, which is frequently misread as a reading disability.
Depth perception
Requires both eyes working together properly, and its absence can indicate an alignment problem needing attention.
Colour vision
Worth establishing early. Colour deficiency affects how a child interprets colour-coded classroom material, and knowing about it changes how a teacher presents work.
Eye health
Full examination for conditions that occur in children, including some that are serious and treatable when found early.

Amblyopia and why early matters so much

Amblyopia, commonly called lazy eye, develops when one eye sends a poorer image to the brain and the brain begins to suppress it. It is the most common cause of vision loss in children, and crucially it is treatable when caught early and much harder to treat later.

The visual system develops through roughly age eight. Treatment during that window can restore vision in the affected eye. After it, the opportunity narrows considerably.

Amblyopia frequently produces no outward sign at all. The child sees fine with the good eye and has never known anything different, so nothing gets reported. This is the strongest argument for examining children before they can tell you anything is wrong.

If your child is becoming nearsighted

Childhood myopia is increasing worldwide and it is no longer something to simply correct and accept. If your child's prescription has increased at each of the last two exams, that progression can be slowed.

Myopia management, using orthokeratology, low-dose atropine or specially designed lenses, changes where the prescription finishes at the end of growth. That matters because adult myopia carries lifetime risk of retinal detachment, glaucoma and macular problems that scales with the final prescription.

What the appointment is like

Children's exams are adapted to the child. For infants and toddlers we use objective techniques that require no response at all, using lights, lenses and observation. For preschoolers we use pictures and shapes rather than letters.

We do not need a child to sit still and cooperate perfectly to get good information, and parents should not arrive anxious about that. We do this constantly. Bringing a favourite toy helps, and so does scheduling when your child is normally alert rather than at nap time.

Who this is for

  • Infants at around six months for their first exam
  • Preschoolers before starting school
  • Any child who failed or was flagged by a school screening
  • Children struggling with reading or homework
  • Children with headaches, eye rubbing or an eye that turns
  • Children with a family history of amblyopia, strabismus or high prescriptions
  • Any child whose prescription is increasing year over year

Our process

Every patient goes through the same sequence, so you always know what happens next.

  1. 1

    Parent conversation

    Your observations, the pregnancy and birth history where relevant, developmental milestones and family eye history.

  2. 2

    Age-appropriate vision testing

    Objective techniques for infants, pictures and shapes for preschoolers, letters for older children.

  3. 3

    Focusing and teaming assessment

    How the eyes focus and work together. This is where most reading-related problems are found.

  4. 4

    Refraction

    Determined with techniques that do not depend on the child answering reliably.

  5. 5

    Eye health examination

    Full health assessment including the retina and optic nerve.

  6. 6

    Explanation and plan

    We explain findings to you and, where age-appropriate, to your child. Children cooperate better with treatment they understand.

Related care

Children's Eye Exams questions, answered

My child passed the school screening. Do they still need an exam?

Yes. Screenings check distance acuity and very little else. They routinely miss farsightedness, focusing problems and binocular vision disorders, which are precisely the issues that make reading and schoolwork difficult. A passed screening is not evidence of healthy vision.

How can you examine a baby who cannot talk?

With objective techniques that need no response. We use light reflexes, lenses and direct observation of how the eyes respond and align. We can determine refractive error and assess eye health without a single answer from the child.

At what age should my child have their first eye exam?

Around six months. It surprises most parents, but this is when conditions like significant refractive error, alignment problems and structural abnormalities are most treatable. Then around three, before school, and annually after.

Will my child need to be dilated?

Often yes for children, and for a genuine reason: children have very strong focusing ability that can mask their true prescription. Dilating relaxes that focusing so we measure accurately rather than measuring their effort. For older children Optomap may replace dilation for the retinal portion.

Could a vision problem be mistaken for a learning difficulty or ADHD?

It happens, and it is worth ruling out. A child who cannot sustain focus at near, or whose eyes do not team properly, avoids reading, loses concentration during near work, and appears inattentive. That looks like an attention problem and is a treatable vision problem. An eye exam is a cheap and quick thing to rule out first.

How much does a children's eye exam cost?

Most vision plans cover annual paediatric exams. We verify your benefits before the appointment and tell you any out-of-pocket cost in advance. Cost should never be the reason a child goes unexamined, so ask us and we will work through the options.

Book an appointment with a doctor who has time for you

We schedule 2 patients an hour, so your exam is unhurried and your questions get answered. Most patients are seen within a few days.

Book Appointment (480) 706-3937