Childhood Eye Exams

Many parents believe that the vision screening their children receive from their school nurse is sufficient. This screening will determine the child’s distance vision but what is missing is the near vision. Very few eye screenings include this much-needed exam. Just as children should visit the pediatrician and the dentist, they should also see us to screen for vision problems.

A child's comprehensive eye examination should include testing of the following visual skills, all of which are important aspects of normal, healthy vision.

Acuity - Distance Vision: Visual acuity (sharpness, clearness) at 20 feet distance.

Acuity - Near Vision: Visual acuity for short distance (specifically, reading distance).

Focusing Skills: The ability of the eyes to maintain clear vision at varying distances.

Eye Tracking and Fixation Skills: The ability of the eyes to look at and accurately follow an object; this includes the ability to move the eyes across a sheet of paper while reading, etc.

Binocular Vision or Fusion: The ability to use both eyes together at the same time.

Stereopis: Binocular (two-eyed) depth perception.

Convergence and Eye Teaming Skills: The ability of the eyes to aim, move and work as a coordinated team.

Color Vision: The ability to differentiate colors.

Reversal Frequency: Confusing letters or words (b, d; p, q: saw, was; etc.)

Visual Memory: The ability to store and retrieve visual information.

Visual Form Discrimination: The ability to determine if two shapes, colors, sizes, positions, or distances are the same or different.

Visual Motor Integration: The ability to combine visual input with other sensory input (hand and body movements, balance, hearing, etc.); the ability to transform images from a vertical to a horizontal plane (such as from the blackboard to the desk surface).

The following are pediatric vision conditions that are not detected through the 20/20 eye chart test alone:

Amblyopia (Lazy eye): Reduced vision in an eye that has not received adequate use during early childhood.

Hyperopia: A refractive condition that makes it difficult to focus at near viewing distances (i.e., reading distance).

Strabismus (Deviating Eyes): Children with strabismus may initially have double vision. This occurs because of the misalignment of the two eyes in relation to one another.

Convergence Insufficiency Disorder: Convergence Insufficiency (CI) is a common binocular (two-eyed) vision disorder in which the eyes do not work at near easily. An eye teaming problem in which the eyes have a strong tendency to drift outward when reading or doing close work (exophoria at near). If the eyes do drift out, the person is likely to have double vision.