vision screenings should not replace eye exams

Vision Screenings vs. Eye Exams: What Is Best for Kids? An Eye Doctor’s Expert Opinion

Did your child pass the vision screening at school? You may be thinking great, my child has perfect vision! But did you know your child can pass a vision screening and still have visual conditions not caught by the screener that can affect their learning and ability to be successful at playing sports? This is why I recommend that vision screenings should not replace eye exams.

Knowing the distinction between a vision screening and a comprehensive eye exam is vital for keeping your child’s eyes healthy.

This post was written and reviewed by Dr. Dana Spearin, an optometric physician who is an avid advocate for pediatric eye exams. You’ll learn why opting for regular eye examinations is essential for children and how these tests can detect issues beyond what standard vision screenings might reveal. 

Additionally, Dr. Spearin (from Luke Knows) gives insight into when it is most appropriate to schedule these critical assessments with an optometrist so that you can ensure the best possible care for your child’s precious sight.

Photo cred: Pexels

What Are Vision Screenings?

A vision screening is a quick and rough estimate of how well your child is seeing. It can spot potential vision problems, but it’s not as thorough and accurate as a comprehensive eye exam completed by your local eye doctor.  

Eye screenings are commonly done at your pediatrician’s office or school vision screenings. They are done by checking each eye’s vision one at a time by reading a chart of letters or with handheld devices that estimate your eye’s prescription with infrared light. 

What is an Eye Exam?

An eye exam is a thorough evaluation to identify vision issues and ocular diseases, typically administered by an optometrist or ophthalmologist. 

An optometrist will not only assess visual acuity, or how well your child can see up close and far away, but will also do an in-depth assessment of your child’s ability to use their eyes together as a team, eye movement capabilities, focusing skills, color vision, and depth perception. 

Vision Screenings vs. Comprehensive Eye Exams

Vision screenings may help catch some vision problems early, but they don’t give a complete picture of your child’s eye health. Hence, getting regular eye exams from an optometrist or ophthalmologist is essential starting at six months old

Key Takeaway: Vision screenings should not replace eye exams even if your child passed the vision screening test.

Why Regular Eye Exams are Important for Children

Eye exams can detect early signs of eye diseases like amblyopia, strabismus, refractive errors, and eye teaming and focusing conditions. They can also help detect systemic conditions like diabetes and hypertension.   If not caught early, these conditions can harm your child’s ability to read, learn, and play sports. 

Regular eye exams starting at six months old can ensure proper care for children’s eyesight during critical developmental years. It is recommended that your child’s first comprehensive eye exam be done between six months to 12 months. Your child is not too young to get accurate and age-appropriate results. Optometrists have special tools and training to evaluate your infant’s vision. 

Why Eye Exams Trump Vision Screenings for Kids

Comprehensive eye exams are superior to vision screenings for children because they provide a more thorough evaluation of their vision and eye health. Eye Exams can:

  • Detect subtle issues: Eye exams can identify subtle vision problems that screenings may miss, allowing for timely treatment and preventing complications.
  • Evaluate overall eye health: Eye exams also assess the overall health of your child’s eyes, detecting signs of disease or injury that could affect their vision later on.
  • Provide accurate results: Vision screenings are inaccurate and can miss as much as 75% of children with vision problems.  On the other hand, eye exams use advanced equipment and techniques to ensure precise measurements and diagnoses.
  • Offer tailored recommendations: After a thorough examination, eye care professionals can offer personalized advice regarding eyewear prescriptions, further testing if needed, and referrals to other health care specialists.

Regular in-person eye exams establish a baseline for your child’s visual development, allowing for close monitoring of any changes over time. By choosing comprehensive eye exams over basic vision screenings, you invest in your child’s long-term visual health and ensure academic and social success.

Key Takeaway: Vision screenings can miss up to 75% of children with vision problems. A comprehensive eye exam is more accurate and can ensure your child is visually set up for academic and social success. 

When Should Kids Get Their Eyes Checked?

It is essential to schedule regular in-person eye exams for your kids to prevent serious problems later.

The American Optometric Association recommends an in-person exam to be done between the ages of 6-12 months, at least once between the age of 3-5 years, and annually after that.  

Why Early Eye Exams Matter

Many vision problems develop during childhood, so early detection means better long-term outcomes.

Children grow rapidly, and congruently their eyes grow and change quickly over the first 6-7 years of life, with the first year of life resulting in the most changes.

For example, newborns can’t see details but can only see in black and white. This allows them to find their mother’s nipple to breastfeed. However, only a few months later vision improves significantly. Now your baby can start seeing details and colors and study your face more clearly. Ultimately this period is critical in terms of vision development because if proper intervention occurs, it can alter their ability to learn, play sports, self-esteem, and mental well-being.  

Visit a Pediatric Eye Specialist

For accurate assessments, it is best to schedule with an optometrist or ophthalmologist who is comfortable assessing and treating children. Many optometrists will have videos, toys, and fun lights to capture your child’s attention throughout the exam.

They can identify common issues like amblyopia, crossed eyes, convergence insufficiency,  and refractive errors. These vision conditions can be treated with glasses, vision therapy, and in some cases, surgery. 

Conclusion

As parents, we want our kids to have 20/20 vision, but relying on vision screenings alone won’t cut it. Eye exams are the real MVPs for detecting potential issues early on and ensuring our children have healthy eyesight. 

According to the American Optometric Association, kids should have their first eye exam at six months old, again at three years old, and then annually after that.

Be sure to schedule an appointment before your child is squinting at the whiteboard!

Key Takeaway: Vision screenings should not replace eye exams

FAQs about Vision Screening vs. Eye Exams

Vision exams are crucial for the early detection of eye problems, especially in children, to identify issues that may affect their learning, development, and self-esteem. Comprehensive eye exams are essential for optimal ocular health, involving thorough evaluations by optometrists or ophthalmologists to assess visual acuity, eye health, and function.

Vision screenings are inaccurate and provide little information about your child’s eyes. They can miss up to 75% of children with visual conditions and problems.

Vision screenings are a quick assessment of a child’s vision using simple tests to detect possible abnormalities or deficiencies that require further evaluation by an eye care professional. Many vision screenings are done by school nurses and at well-child checks. Because vision screenings are inaccurate, they can give parents a false sense of security when their child passes the screening test. As a result, this may delay the child from seeing an eyecare professional and getting the intervention and help they need. 

Vision screenings are often a quick method to identify potential vision problems; however, they may need to be more thorough and reliable than a complete eye examination conducted by an experienced eye doctor. On the other hand, comprehensive eye exams provide a more detailed assessment of your child’s eyes, including identifying any underlying conditions that could lead to future visual impairment if left untreated.

Young children rarely complain about their eyes. They think they view the world just like everyone else and that their vision is normal. They have nothing to compare their vision to, so they don’t think to mention it.

It is common for older kids to start “complaining” about their vision around the age of 10 years. This is when the font size in school decreases and reading comprehension increases. 

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