The first three years of life are critical in the development of good vision. Vision problems affect 2-4% of children under 3 years of age, 5-10 % of preschoolers and 20-25% of school-aged children. Visual acuity measurement should be part of the well-child examination at the earliest possible age depending on child's ability and cooperation (often at about 3 years of age). Young children generally do not complain about poor vision. Serial screening in the medical home is the most effective approach to early detection and provides the best opportunity for effective treatment. According to the American Academy of Pediatrics, examination of the eyes should be performed beginning in the newborn period and at all well-child visits.*
- Strabismus and refractive errors can lead to amblyopia – reduced vision due to lack of visual stimulation during early childhood. Equal input from both eyes is necessary for normal development of the brain’s visual cortex. In addition to permanent vision loss, undetected vision abnormalities can lead to cognitive, emotional, neurological and physical impairment.
- Injury to the eyes may occur at any age. Many eye and vision injuries can be prevented by simple measures such as appropriate toy selection for the age and maturity level of the child and the use of protective eyewear during sport and hobby activities.
- Children with global developmental delay or a family history of eye problems such as congenital cataracts, retinoblastoma, genetic disorders and metabolic disease should have an eye examination. Very premature infants and some other infants with health problems need an examination by an ophthalmologist and continued monitoring.
- Parents are often the first to notice an eye or vision problem. If a parent expresses concern, he/she should be encouraged to get a diagnostic exam.
*AAP Policy Statement - Eye Examination in Infants, Children, and Young Adults by Pediatricians' (2003, reaffirmed 2007)