From the first moment you meet them (and probably before) you’ve done everything in your power to keep your little ones safe and sound. From doctor visits to child care, you’ve probably researched high and low to help make informed choices for your child. But do you know when your child should receive their first eye exam?

You’re not alone if you don’t! In fact, a survey from VSP Vision Care and market research agency, YouGov, found that a whopping 88 percent of parents did not know that their children should receive their first eye exam at six months old. And, twice as many parents worry about their children’s dental problems vs. their vision issues – even though most children lose their baby teeth by age 12.

We caught up with busy mom and VSP network eye doctor, Dr. Jennifer Wademan, to weigh in on the best age to get an eye exam, what to expect at the appointment, and how to find the right eye doctor for your family. Read on for our Q&A with Dr. Wademan.

photo: iStock

At what age should my child have their first comprehensive eye exam?

Dr. Wademan: Many parents don't realize this, but the first comprehensive eye exam should be around six months of age. You may have had vision screenings with your pediatric doctor, but a comprehensive eye exam is recommended at the age of six months. 

photo: iStock

Wow! That's surprising. Six months seems very early; why does my baby need an eye exam at such an early age?

Dr. Wademan: A lot of important visual skills are developing and should be present around six months of age. That includes the baby’s focusing ability—the ability to fixate on something, usually mom or dad’s face. Also, color vision and depth perception. Those are really important skills that we want to make sure are present at that age. 

Especially with babies it’s difficult to tell; they’re not going to be able to tell you what they're seeing or what they're not seeing, so an eye exam can help determine those visual skills.  

photo: iStock

How often should my child have eye exams?

Dr. Wademan: The first one should be at six months and then again at three years. The next one should be five or six years old, that age right before they start kindergarten. That’s usually a really good protocol. And then after that an annual comprehensive eye exam is a must. 

Remember that babies and children are building a visual library so it's really important to make sure that what they're seeing is clear and unobstructed, and that there’s no visual impairment.  That way, if there are any issues present, we can address it earlier on as they're building a more accurate visual library which is essential for their growth and development. This is especially important for their success as they approach school age.

photo: iStock

Is there anything I can do ahead of time to help my child feel more comfortable at their eye exam?

Dr. Wademan: It depends on the age of your child: for babies at six months, making sure you're not scheduling the appointment right at nap time or right when the baby needs to eat.

For an older child, I think it's important just to prepare the child by talking to them. Tell them what to expect and address any concerns or fears they may have before the appointment. I often tell parents to bring your child in at the same time as your exam, let them sit on your lap, so they can watch you do the exam first. Then, when it's time for the child's exam, it's a little easier: they know what to expect. 

Really an eye exam is probably the easiest health exam for a child (I'm a little biased). We try to make the experience fun and exciting with toys, cartoons and a treasure chest.

Are there any signs that I should look for to know if my baby/child has vision problems?

Dr. Wademan: It’s important to bring your baby or child in to an eye doctor because their regular pediatric exam is an eye screening, not a comprehensive exam. A comprehensive eye exam goes beyond just clear vision for kids— it can play an important role in mobility and eye coordination, the early detection of chronic diseases like diabetes, and creating a baseline for when changes in vision occur as the child develops.

Another thing parents may notice are eyes not tracking together (lazy eye) in children. It’s important to keep in mind that babies can’t really articulate if something is blurry. Even with older kids, when they're hitting that school age, kids can't really articulate blurry versus clear vision. If a child’s vision is blurry, that’s the picture they’re looking through and oftentimes they don’t know that they should be seeing things any differently.

photo: iStock

Beyond ensuring clear vision, are there other eye health and overall health-related issues the eye doctor is looking for?

Dr. Wademan: In addition to vision issues, there are other diseases that can be present, so it’s important to create a baseline at a very young age. Diabetes, eye pressure, congenital cataracts, lazy eye, all of these can occur in kids. The younger they are and the earlier we are able to treat, the better the prognosis is long term for their overall vision and health.

Starting from birth to about eight years old is where we see a lot of developmental changes and so some of those conditions that we can treat earlier on, means that they're going to be seeing clear and comfortable for years to come. There's a critical window where you want to check everything out. I’m a mom and I noticed my daughter, who is six, wasn’t doing as well in school as I thought she would. I took her to get an eye exam and it turned out she needed glasses. Keep in mind, a child’s vision can change out of the blue and fairly quickly. It’s like their shoe size— it can stay the same for a year but then change two sizes in three months. So, you just never know unless you have that comprehensive eye exam.

photo: iStock

Anything parents should know about dilation? Is dilation safe for kids?

Dr. Wademan: Dilation is safe for kids and is done for two reasons:

The first reason is to get a better look inside the back of the eye. Think of it like window opening, dilation makes it easier to see through thus I can see in the eye more extensively.

Secondly, it relaxes a child's whole focusing system, which allows me to get a much more accurate representation if the child has a prescription whether for nearsightedness, farsightedness or astigmatism. Parents should know the eye drops can last anywhere from four-to-12 hours, and sometimes your child will get a bit tired. There aren’t really any other side effects, although for some children the eye drops may sting a little bit.  

photo: iStock

What are the most common issues you see in children during eye exams?

Dr. Wademan: Moderate-to-higher amounts of prescriptions, whether it’s nearsightedness, farsightedness or sometimes astigmatism. The other thing I often see is lazy eye, where one eye turns out and both eyes are not focusing and working together. Any of these issues can lead to vision problems and reduced vision into adulthood if not addressed early on.

photo: iStock

I’m not sure how to get started. What should I look for when selecting an eye doctor for my kid? Do I need to find an eye doctor who has experience with baby eye exams before making an appointment?

Dr. Wademan: If you don't currently have an eye doctor, visit VSP.com to find an eye doctor near you. I see a lot of families from baby to teenager. Just like with any other provider, it’s important to find someone you’re comfortable asking questions and that you’re at ease with. There are specific pediatric eye doctors, but many eye doctors see babies and children through adulthood.

photo: Dr. Jennifer Wademan

About Jennifer Wademan, O.D.

Dr. Jennifer Wademan is a VSP Network Eye Doctor currently practicing at Bidwell Optometry in Folsom, CA. She graduated from Southern California College of Optometry in 2008 and practices comprehensive optometry with training in family eye care, contact lens fittings, ocular disease, co-management of laser vision/cataract surgery and pediatrics.

​Dr. Wademan enjoys her many roles at Bidwell Optometry, but also cherishes her role as mom of two girls, and a wife to an amazing husband. She is passionate about connecting with patients on a personal level and educating on a range of eye health topics. Dr. Wademan is a member of the American Optometric Association, the Calif. Optometric Association, and the Sacramento Valley Optometric Society.

Want to learn more about eye health for kids and find the right eye doctor for your family? Visit VSP.com.

—Amber Guetebier

featured photo: iStock