When complex vision problems require specialized evaluation and treatment

About vision: Children’s vision


There are many things you can do to help your child's vision develop. First, proper prenatal care and nutrition can help your baby's eyes develop before birth. Then at birth, your baby's eyes should be examined for signs of congenital eye problems.

At about six months, you should take your baby to an eye doctor for a thorough exam. The optometrist will test for excessive or unequal amounts of nearsightedness, farsightedness, or astigmatism, eye movement ability and eye health problems. Vision development and eye health problems can be more easily corrected if treatment begins early.

Unless you notice a need or your eye doctor advises otherwise, your child's next exam should be at about age three, then again before he or she enters school, and every two years thereafter.


During the first four months, your baby should begin to follow moving objects with the eyes and reach for them, first by chance and later more accurately, as hand/eye coordination and depth perception develop.

To help, use a nightlight or dim lamp in your baby's room; change the crib's position and your child's position in it frequently; keep reach-and-touch toys within eight to twelve inches; talk to your baby as you walk around the room; alternate right and left sides with each feeding; hang a mobile above and outside the crib.

Between four and eight months, your baby should begin to turn from side to side and use his or her arms and legs. Eye movement and eye/body coordination skills should develop further and both eyes should focus equally.

You should enable your baby to explore different shapes and textures with his or her fingers; give your baby the freedom to crawl and explore; hang objects across the crib; play "patty cake" and "peek-a-boo" with your baby.

From eight to twelve months, your baby should be crawling and pulling himself or herself up. He or she will begin to use both eyes together, judge distances and grasp and throw objects with greater precision. Don't encourage early walking — crawling is important in developing eye/hand/foot/body coordination; give your baby stacking and take-apart toys; provide objects your baby can touch, hold and see.

From one to two years, your child's eye/hand coordination and depth perception will continue to develop. You can encourage walking; provide building blocks, simple puzzles and balls; provide opportunities to climb and explore indoors and out.
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In the preschool years your child develops visually guided eye/hand/body coordination, fine motor skills and the visual motor skills necessary to learn to read.

Watch for signs that may indicate a vision development problem, including a short attention span for the child's age; difficulty with eye/hand/body coordination in ball play and bike riding; avoidance of coloring and puzzles and other detailed activities.

Read aloud to your child and let him or her see what you're reading; provide a chalkboard, finger paints and different shaped blocks and show your child how to use them in imaginative play; provide safe opportunities to use playground equipment like a jungle gym and balance beam; allow time for interacting with other children and for playing independently.

By age three, your child should have a thorough optometric eye exam to make sure vision is developing properly and there's no evidence of eye disease. If needed, your doctor can prescribe treatment including glasses and/or vision therapy.

To make your child's exam a positive experience:

  • Make an appointment early in the day; allow about one hour.
  • Talk about the examination in advance and encourage your child's questions.
  • Explain the examination in your child's terms, comparing the E chart to a puzzle and the instruments to tiny flashlights and a kaleidoscope.

Unless your doctor of optometry advises otherwise, your child's next eye exam should be at age five. By comparing results of the two examinations, your optometrist can tell how well your child's vision is developing.
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Your child's eyes are constantly in use in the classroom and at play, so when his or her vision is not functioning properly, learning and participation in recreational activities will suffer.

The basic vision skills needed for school are:

Near vision: Ability to see clearly and comfortably at 10 to 13 inches

Distance vision: Ability to see clearly and comfortably beyond arm's reach

Binocular coordination: Ability to use both eyes together

Eye movement skills: Ability to aim the eyes accurately, move them smoothly across a page and shift them quickly and accurately from one object to another

Focusing skills: Ability to focus both eyes at the proper distance to see clearly and to change focus quickly

Peripheral awareness: Awareness of things located to the side while looking straight ahead

Hand/eye coordination: Ability to use the eyes and hands together

If any of these or other vision skills is lacking or not functioning properly, your child will have to work harder. This can lead to headaches, fatigue and other eyestrain problems.

Tell your optometrist if your child frequently:
  • Loses their place while reading
  • Avoids close work
  • Holds reading material closer than normal
  • Tends to rub their eyes
  • Has headaches
  • Turns or tilts head to use only one eye
  • Makes reversals when reading or writing
  • Uses finger to maintain place when reading
  • Omits or confuses small words when reading
  • Consistently performs below potential

Since vision changes can occur without you or your child noticing, your child should visit the optometrist at least every two years—more frequently if specific problems or risk factors exist.

Remember, a school vision or pediatrician's screening is not a substitute for a thorough eye examination.
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