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Tips for detecting vision problems in your kids

When should your child get an eye exam? Marianne McGinnis of Prevention offers advice on the recommended screening age and the types of tests.
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/ Source: TODAY

According to the American Optometric Association, it's estimated that one in four children can't see properly. And that may result in irreparable damages — so knowing what to watch for and early testing is key. Amy O'Connor, deputy editor of Prevention, visited “Today” to discuss some vision screening tips, which are featured in the July issue of the magazine. Here's an excerpt:

The Eyes Have It: 1 in 4 kids has undetected vision problems. Here's what to watch for  By Marianne McGinnis

Shama Albright's twins learned to talk, crawl, and walk around their Seattle home within days of each other. But shortly after they turned 2, Albright noticed that Tyler was clumsier, shier, and more easily distracted than his brother. Light seemed to bother him, too. The pediatrician told Albright not to worry — and it wasn't until Tyler was 5 that an optometrist discovered that he was extremely farsighted in one eye and nearly blind in the other. “We were driving home when Tyler put his glasses on for the first time,” says Albright. “When he said, ‘Mommy, I didn't know trees had leaves,’ I broke down. I was furious that it had taken so long to get my son the help he needed.”

Tyler's case is extreme, but many kids struggle with undetected vision problems: The American Optometric Association estimates that 1 in 4 children can't see properly. They recommend regular eye exams beginning at age 3. A recent study by the CDC, however, found that 60% of children younger than age 6 have never had their eyes checked; among school-age children, only 20% have had their vision tested by an eye doctor within the past year.

That's too bad, because earlier treatment is better treatment. The brain is most flexible when it's young, says Jean Ramsey, MD, director of pediatric ophthalmology service at Boston Medical Center and an assistant professor of ophthalmology and pediatrics at Boston University. “By the time you're an adult, your vision is hardwired, but a child's brain is plastic and changeable. Treatment by age 8 or 9 may even repair conditions such as amblyopia [lazy eye].”

Having your child screened with the right sorts of tests at the right time is crucial — but you can't rely on vision screenings at school or even a quick eye-chart check at the pediatrician's. Eye charts miss up to 60% of vision disorders, says Glen T. Steele, OD, chief of pediatrics and vision therapy at the Eye Center at Southern College of Optometry. “Yearly screenings are great for catching big issues, but comprehensive eye exams are when you'll catch the subtle problems,” he explains. A comprehensive exam includes an eye chart plus tests that measure how well your child's eyes move, focus, and work together. Some pediatricians do these additional tests, but many do not.

“All too often we see kids well into their school years who've just discovered they have eye issues,” says Ramsey. “It's heartbreaking to tell parents that their child has poor vision or even is partially blind — especially when you know that earlier detection and treatment could have corrected the problem.” To make sure your child's eyes get the care they need:

Schedule eye exams early and often Most pediatricians will check a child's vision for common problems, such as lazy eye and cross-eye, at each well-child visit starting at 6 months. In addition, your child should have a comprehensive eye exam by an optometrist or ophthalmologist between ages 3 and 5. If she was born prematurely, or if you have a family history of eye conditions such as glaucoma or cataracts, have her vision checked every year thereafter.

Know what to look for Babies are born farsighted and their eyes may drift slightly outward. As the eyes develop, farsightedness diminishes. If your baby's eyes continue to turn outward after 3 months of age, he should be evaluated by an eye doctor. In older children, watch for squinting, frequent headaches, covering an eye to read, or needing to sit in the front row of the classroom.

Give eyes a workout “Balance TV, computer, and video-game time with outdoor play,” says Steele. “Kids use many eye muscles when following a real ball, and that helps develop eye movement control and focusing ability.” You can also exercise your toddler's eyes by encouraging her to follow along as you read to her, pointing to each word.

Optometrists nationwide give free eye exams for babies 6 to 12 months old. Visit to find a doctor in your area.

Marianne McGinnis is a freelance writer in California.

For more information, visit prevention.com.