The Importance of Vision Screening for Young Children (0-5 years)

Toddlers in glasses… right up there with puppies on the cuteness scale, a very official medical scale! But in all seriousness, as pediatricians, vision screening is very important to us.  

Pediatricians examine an infant’s eyes starting at birth.  At each well visit, we will use an ophthalmoscope to make sure that the eyes are aligned and that the surface of the eye are clear.  We look at how the light bounces off the retina (the back of the eye) – this is what gives a “red eye” appearance in your photos.  

We may shine a light into each eye to watch the pupils contract and watch the movements of the eyes.  All of this gives us a lot of information about the health of your child’s eyes.

In addition, we now use a photo screener device to assess the eye and look for potential problems.  Currently in our office, we are using a camera with a specialized flash and vision screening program.  It can detect several important abnormalities of the eyes including:

  • Strabismus: eyes are not aligned properly
  • Astigmatism: abnormal curvature of the eye
  • Hyperopia: farsightedness
  • Myopia: nearsightedness
  • Anisometropia: a significance difference in vision between the two eyes

Why do these conditions matter?  They can all lead to vision problems including amblyopia – which occurs when vision is reduced in one eye. 

For example, if one eye can see much better than the other eye (in the case of anisometropia), or one eye is not aligned with the other eye (strabismus), then the brain receives different input from each eye.  Over time, the brain begins to “ignore” the input from one eye and vision is reduced.  

The good news is that these conditions are treatable… just as long as they are diagnosed early in childhood!  Currently, we are expanding the use of our photo screener to the two-year-old and three-year-old well visits.  For our four-year-old visits, most children can be screened by having them read the eye chart (which is made up of symbols instead of letters).  

All children in Illinois require a full eye exam with an ophthalmologist or optometrist prior to entering kindergarten.  If there are any abnormalities detected during any of these visits, then your child is referred on to a pediatric ophthalmologist for further treatment.  

Parents can play an important role in identifying vision problems as well.  If you see any of the following signs, please discuss them with your pediatrician:

  • If your child is older than three months old and is not looking at your face and tracking your movement with both eyes
  • If your child is older than four months old and has an eye that turns inward or outwards, i.e. a “lazy eye”
  • White or grayish colored area on the pupil (black center of the eye)
  • Eyes that flutter quickly from side to side or up and down

Vision screening plays an important role in identifying problems early in order to prevent permanent vision impairment or loss.  Those adorable toddlers in glasses are a reminder that early treatment is highly successful. And a toddler wearing glasses walking a puppy = 100% cuteness!


Written by: Dr. Rachel Elwell