Why a full exam, even if your child seems fine
Young children rarely complain about their vision. They assume the way they see is how everyone sees. The AOA notes that preschool screenings can miss a large share of children with vision problems, and that conditions such as amblyopia (lazy eye) and strabismus (eye turn) often develop in the preschool years. A school-age child can also pass a distance chart and still struggle with focusing, tracking or eye teaming, which affect reading.
Signs worth mentioning to the doctor include:
- Sitting close to screens or holding books very near
- Squinting, tilting the head, or covering one eye
- Frequent eye rubbing or blinking
- An eye that turns in or out
- Headaches, losing their place while reading, or avoiding close work
The AOA notes that some of these can be mistaken for attention problems.
What happens during the exam
The steps depend on your child’s age and what the doctor needs to check.
- History. The doctor asks about your child’s health, birth history, development, school, family eye history and any concerns you have noticed.
- Vision. Older children read letters. Younger children match shapes or pictures. For very young children, the doctor can watch how their eyes follow objects and lights.
- Eye alignment and teamwork. Simple tests with lights, toys and covers check how the eyes move and work together.
- Focusing and prescription. The doctor shines a light into the eyes with lenses to measure whether glasses are needed. This works even when a child cannot answer questions.
- Eye health. The doctor examines the front and back of each eye, often after drops.
- Results. You hear what was found, whether glasses would help, and when to come back.
About the eye drops
Many children’s exams include drops. Dilating drops widen the pupil so the doctor can see the back of the eye. A related type, cycloplegic drops, temporarily relaxes the focusing muscles. AAPOS describes this as the most reliable way to measure whether a child needs glasses, because children can otherwise focus through part of their prescription.
What to expect:
- Brief stinging when the drops go in is common. Allergic reactions are rare.
- Light sensitivity and blurry near vision are the main effects.
- Duration is usually 4 to 24 hours, sometimes longer in light-colored eyes or with stronger drops.
- Sunglasses or a brimmed hat help on the way home.
- School: most children can return, though reading may be harder that day.
How to talk with your child beforehand
Keep it short, honest and upbeat:
- “The eye doctor is going to look at your eyes and see how well they work.”
- “You might look at pictures and lights, and wear some funny glasses.”
- “There may be eye drops. They might sting for a few seconds, then they feel fine.”
- “Your eyes might feel bright and blurry afterward, so we will bring sunglasses.”
Avoid promising that nothing will be uncomfortable, and avoid words like “shot” or “hurt.” Pretend play at home, such as looking at each other’s eyes with a flashlight, can make the visit feel familiar.
What to bring
- Your child’s glasses, if they have any, including old pairs
- Vision and medical insurance cards
- Any school or pediatrician screening results
- A list of medications and allergies
- Notes on what you or teachers have noticed
- Family eye history (eye turns, lazy eye, glasses at a young age)
- Sunglasses or a hat for after the drops
- A favorite small toy, snack or comfort item for the wait
Timing and who comes along
Schedule the visit when your child is usually rested and fed. Mornings often work well for younger children. Plan for a parent or legal guardian to come and stay for the visit, since the doctor will want to hear your observations and explain the results to you. If someone else will bring your child, ask us in advance what we need from you.
If glasses are recommended
Children’s frames need to fit securely so the child looks through the lenses, not over them. Arms that hold behind the ears and a bridge that suits a small nose matter more than room to grow. Our guide to frame sizes explains how kids’ frames are measured. Ask the optician about impact-resistant lens materials such as polycarbonate or Trivex, which are lightweight choices for active children.
Next step
Read more about children’s eye exams, then request an appointment and tell us your child’s age. We will confirm the ages we see when you call.