Eye Exams…When to Start and Why

According to the American Optometric Association (AOA), infants should have their first eye exam at 6 months of age. Children then should have additional eye exams at age 3, and just before they enter the first grade — at about age 5 or 6.

For school-aged children, the AOA recommends an eye exam every two years if no vision correction is required. Children who need eyeglasses should be examined annually or as recommended by their eye doctor.

The AOA stresses early eye exams for children because 5 to 10 percent of preschoolers and 25 percent of school-aged children have vision problems. Early eye exams also are important because children need the following basic skills related to good eyesight for learning:

  • Near vision           image of eye chart for young children
  • Distance vision
  • Binocular (two eyes) coordination
  • Eye movement skills
  • Hand-eye coordination
  • Focusing skills
  • Peripheral awareness

For these reasons, some states require a mandatory eye exam for all children entering school for the first time.

The American Academy of Ophthalmology (AAO) says on its Web site that your family doctor or pediatrician likely will be the first medical professional to examine your child’s eyes. If eye problems are suspected during routine physical examinations, a referral might be made to an eye doctor for further evaluation. Eye doctors have specific equipment and training to assist them with spotting potential vision problems.

Babies should be able to see as well as adults in terms of focusing ability, color vision and depth perception by 6 months of age. To assess whether a baby’s eyes are developing normally, the doctor typically will use the following tests:

  • Tests of pupil responses evaluate whether the eye’s pupil opens and closes properly in the presence or absence of light.
  • “Fixate and follow” testing determines whether your baby’s eyes are able to fixate on and follow an object such as a light as it moves. Infants should be able to fixate on an object soon after birth and follow an object by the time they are 3 months old.
  • Preferential looking involves using cards that are blank on one side with stripes on the other side to attract the gaze of an infant to the stripes. In this way, vision capabilities can be assessed without the use of a typical eye chart.

 Preschool-age children do not need to know their letters in order to take certain eye tests. Some common eye tests used specifically for young children include:

  • LEA Symbols for young children are similar to regular eye tests using charts with letters, except that special symbols in these tests include an apple, house, square and circle.
  • Retinoscopy is a test that involves shining a light into the eye to observe the reflection from the back of the eye
  • Random Dot Stereopsis testing uses special patterns of dots and 3-D glasses to measure how well your child’s eyes work together as a team.

AAO offers the following reminders:

  • Appropriate vision testing at an early age is vital to insure your child has the visual skills he or she needs to perform well in school.
  • A child who is unable to see print or view a blackboard can become easily frustrated, leading to poor academic performance.
  • Some vision problems, such as lazy eye, are best treated if they are detected and corrected as early as possible while the child’s vision system is still developing.

Ways to answer the “Why Do I Have to Wear Eye Glasses Question”

Why do I have to wear glasses? A tough question from a child in the first or second grade who doesn’t want to look different from his or her classmates.

Some good answers for why a child has to wear glasses can be found in the following books.


Ages 3-5
Baby Duck and the Bad Eyeglasses, by Amy Hest (Candlewick Press)


Ages 5-8
Dogs Don’t Wear Glasses by Adrienne Geoghegan (Crocodile Books)

Libby’s New Glasses, by Tricia Tusa (Holiday House)

All the Better to See You With, by Margaret Wild (Whitman and Co)

Winnie Flies Again, by Korky Paul and Valerie Thomas (Oxford University Press)

X-Ray Mable and Her Magic Specs, by Claire Fletcher (Bodley Head)

The Arthur Books, by Marc Brown (Red Fox)

Glasses. Who needs ‘Em?, by Lane Smith (Viking)

Luna and the Big Blurr, by Shirley Day

Chuckie Visits the Eye Doctor by Luke David






This guest post is courtesy of  Ros Guerrero who invented Ficklets, a great way to dress up a child’s eyeglasses so they look hip and cool and not geeky. Prescription eyeglasses are expensive. Ficklets give tired, old eyeglasses a quick, affordable update.

Who knew my “couch potato” idea would go this far. Ficklets was inspired by my 14 year old special needs daughter, Gem, who’s worn glasses since she was 6 years old. The concept was born while I was literally sitting on the couch watching my favorite TV show when Gem walked into the kitchen. As she stood behind the breakfast counter, I turned to look at her and the only part of her I could see were her eyeglasses. As I stared at her glasses, it got me thinking – Wow, time to add some color and life to your tired, old glasses. This I believe was my “a-ha” moment.

The first idea was to simply add adhesive decals, but decided I wanted something more versatile to mix and match with her outfits (hey, a girl’s gotta have options, right?) and thought an interchangeable charm would be the way to go. I later developed a working charm and had Gem wear it to school for the first time. With much delight, Gem brought home a note from her teacher saying Gem’s eyeglasses received so much attention from both her peers and many of the school staff. This was when I thought… hmm, I think I should run with this idea.

The next step was to come up with a name. After much thought, the word “fickle”, which means to “change often”, came to mind as it appropriately described how much fun Gem and I were having changing out her charms to coordinate with her outfits. As I worked to refine and expand my prototype designs, I deliberated more on the word fickle to come up with a made-up name, a tip I learned from Sara Blakely, the inventor of Spanx. After a few sleepless nights and several scribbled pages, the name “Ficklets” was born. We launched our website and filed patent in spring 2007 [by the way, we were granted a patent  in September 2009… Yay!!].

I would be remiss if I didn’t re-mention and give sole credit to my daughter for planting the entrepreneurial spirit in me. It’s been my mission to build a business that would not only create opportunities for Gem, giving her some sense of “normalcy”, but also a business that would provide for her to live a quality life long after I’m gone. In my quest to start a business, I’ve dabbled in various ventures over the years–real estate investor, co-owned both a window treatment design and nail salon business. It was by accident that I stumbled on the Ficklets idea and since then my business passion has soared like never before… I knew this was IT!

Visit Ficklets at  www.ficklets.com.


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