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Pediatric Eye Exams

Children's Vision - Girl wearing glasses - Olathe, KS

According to experts, 80% of learning is visual, which means that if your child is having difficulty seeing clearly, his or her learning can be affected.  This also goes for infants who develop and learn about the world around them through their sense of sight.  To ensure that your children have the visual resources they need to grow and develop normally, their eyes and vision should be checked by an eye doctor at certain stages of their development.

Q&A with Dr. Galbrecht

Dr. Diane Galbrecht Answers Your Pediatric Eye Care Questions

How often should children have an eye exam?

Every child should have a comprehensive eye exam to determine if they have normal vision or if they need glasses, and also to see if they need help with any of the learning processes in school. If they can't see normally they can't learn. The first eye exam should be between 6 months old to 1 year old. In addition, before the school year is a good time to come in so if there is a problem, we will catch it before school begins and they will start school on the right foot.


According to the American Optometric Association (AOA) children should have their eyes examined by an eye doctor at 6 months, 3 years, at the start of school, and then at least every 2 years following. If there are any signs that there may be a vision problem or if the child has certain risk factors (such as developmental delays, premature birth, crossed or lazy eyes, family history or previous injuries) more frequent exams are recommended. A child that wears eyeglasses or contact lenses should have his or her eyes examined yearly.  Children’s eyes can change rapidly as they grow.

Eye Exams in Infants: Birth-24 Months

A baby’s visual system develops gradually over the first few months of life. They have to learn to focus and move their eyes, and use them together as a team.  The brain also needs to learn how to process the visual information from the eyes to understand and interact with the world. With the development of eyesight, comes also the foundation for motor development such as crawling, walking and hand-eye coordination.

You can ensure that your baby is reaching milestones by keeping an eye on what is happening with your infant’s development and by ensuring that you schedule a comprehensive infant eye exam at 6 months.  At this exam, the eye doctor will check that the child is seeing properly and developing on track and look for conditions that could impair eye health or vision (such as strabismus(misalignment or crossing of the eyes), farsightedness, nearsightedness, or astigmatism).

Since there is a higher risk of eye and vision problems if your infant was born premature or is showing signs of developmental delay, your eye doctor may require more frequent visits to keep watch on his or her progress.

Q&A with Dr. Galbrecht

Dr. Diane Galbrecht Answers Your Pediatric Eye Care Questions

What eye problems do children have compared to adults?

Children have more binocularity problems compared to adults. Therefore, just because they can see well, doesn't mean they can read well. Many children have problems with accommodation or their ability to focus, which adults don't have. Even if the child has 20/20 vision, they may not be reading up to their grade level due to these problems. If a child does have focusing or accommodation issues, I will refer them to my colleague who is a vision therapy specialist and he will work one on one with the patient to resolve the problem.

Eye Exams in Preschool Children: Ages 2-5 Years

The toddler and preschool age is a period where children experience drastic growth in intellectual and motor skills.  During this time they will develop the fine motor skills, hand-eye coordination and perceptual abilities that will prepare them to read and write, play sports and participate in creative activities such as drawing, sculpting or building.  This is all dependent upon good vision and visual processes.

Q&A with Dr. Galbrecht

Dr. Diane Galbrecht Answers Your Pediatric Eye Care Questions

What is different about a children's eye exam than an adult eye exam?

We run a few extra tests which we don't need to run on adults. Most children's eyes are cycloplegic, therefore I will dilate their eyes, which inhibits their ability to focus, so I can get a perfect reading of their prescription. Additionally, we check their ability to see 3D. Then we determine: Can they fix and follow? Are they able to accommodate from far to near and from near to far? There are some of the extra texts we wouldn't necessarily do on an adult.


This is the age when parents should be on the lookout for signs of lazy eye (amblyopia) - when one eye doesn’t see clearly, or crossed eyes (strabismus) - when one or both eyes turns inward or outward. The earlier these conditions are treated, the higher the success rate.

Parents should also be aware of any developmental delays having to do with object, number or letter recognition, color recognition or coordination, as the root of such problems can often be visual.  If you notice your child squinting, rubbing his eyes frequently, sitting very close to the tv or reading material, or generally avoiding activities such as puzzles or coloring, it is worth a trip to the eye doctor.

Eye Exams in School-Aged Children: Ages 6-18 Years

Undetected or uncorrected vision problems can cause children and teens to suffer academically, socially, athletically and personally.  If your child is having trouble in school or afterschool activities there could be an underlying vision problem. Proper learning, motor development, reading, and many other skills are dependent upon not only good vision, but also the ability of your eyes to work together. Children that have problems with focusing, reading, teaming their eyes or hand-eye coordination will often experience frustration, and may exhibit behavioral problems as well. Often they don’t know that the vision they are experiencing is abnormal, so they aren’t able to express that they need help.

In addition to the symptoms written above, signs of vision problems in older children include:

  • Short attention span
  • Headaches
  • Frequent blinking
  • Avoiding reading
  • Tilting the head to one side
  • Losing their place often while reading
  • Double vision
  • Poor reading comprehension

Q&A with Dr. Galbrecht

Dr. Diane Galbrecht Answers Your Pediatric Eye Care Questions

What do you check for in older children?

As the child gets a little bit older we will focus more on the health of the eye compared to just the binocularity of a younger child. We will look for anything else that may be in the eye that may cause the child problems, such as a corneal disease, or retinal disease, glaucoma, diabetic changes, and these sorts of issues.

The Eye Exam

In addition to basic visual acuity (distance and near vision) an eye exam may assess the following visual skills that are required for learning and mobility:

  • Binocular vision: how the eyes work together as a team
  • Focusing
  • Peripheral Vision
  • Color Vision
  • Hand-eye Coordination
  • Tracking

The doctor will also examine the area around the eye and inside the eye to check for any eye diseases or health conditions. You should tell the doctor any relevant personal history of your child such as a premature birth, developmental delays, family history of eye problems, eye injuries or medications the child is taking. This would also be the time to address any concerns or issues your child has that might indicate a vision problem.

Q&A with Dr. Galbrecht

Dr. Diane Galbrecht Answers Your Pediatric Eye Care Questions

Does insurance cover my child's eye exams?

All vision insurance covers children's eye exams. As for medical insurance, if you are on a newer plan, let's say the past 6 years, then yes, all children under the age of 18 years of age are covered for yearly eye exams.


If the eye doctor does determine that your child has a vision problem, they may discuss a number of therapeutic options such as eyeglasses or contact lenses, an eye patch, vision therapy or Ortho-k, depending on the condition and the doctor’s specialty.   Since some conditions are much easier to treat when they are caught early while the eyes are still developing, it is important to diagnose any eye and vision issues as early as possible.

Q&A with Dr. Galbrecht

Dr. Diane Galbrecht Answers Your Pediatric Eye Care Questions

How do most children come to you? Are they referred to you or do they come for a regular checkup?

I would say it's half/half. Half of my pediatric patients come to me because the school recommended it, or because a parent saw an issue they wanted to check out. The other half come in because they know that most optometrists recommend yearly routine eye exams for children, and they just want to make sure their child's eyes are OK. Of these patients, about 25-30% of the children do actually have a vision problem that we discover during the routine exam.


Following the guidelines for children’s eye exams and staying alert to any signs of vision problems can help your child to reach his or her potential.