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Children’s Eye Tests - When is it Time to See an Optometrist?

Optical Health

Tammy George
By

Little girl being fitted with prescription glasses by an optometrist after an eye test.

We all know how valuable eyesight is. Our children’s eyes need to stay healthy so they can last a lifetime. Poor eyesight not only impacts quality of life but also the development of young children. By school age, a child’s poor eyesight can impact their learning. Around 80% of the information taught in school is presented visually, so good eyesight is vital. 

Many Australian children have hearing checks at birth, but eye tests aren’t usually undertaken until at least six months of age. It takes at least four weeks for a baby to be able to focus on faces and objects and eight weeks to smile at familiar objects. Vision problems can cause a wide range of developmental problems. Everything from crawling and walking to language and social skills can be impacted in the first two years, long before any school learning takes place. 

Some schools offer eye tests for children in their first year or two to pick up any problems that may cause them learning difficulties. Not all schools offer eye tests, so if not, it’s best to make an appointment with an optometrist. A child with undiagnosed sight problems at school may have poor attention spans and behavioural issues, be disinterested, lose their place reading, read slowly or not comprehend what they’ve read.

Optometrist performing a children’s eye test on a little girl.

What Age Should a Child See an Optometrist?

Babies have their eyesight assessed during routine development tests at the GP or community health nurse. A more thorough eye test is recommended by the age of three or at least before a child starts full-time education to pick up any eye problems so they can see clearly when they get to the classroom.

Even if you aren’t concerned about your child’s vision, it’s ideal that your child sees an optometrist every two years to check for any eye problems. Children often can’t tell a parent there’s a problem with their eyesight because they don’t know any different or can’t communicate it. 

Many parents are concerned their child won't be able to have an eye test until they know the alphabet, but this isn't the case. Children’s eye tests use shapes and animals or matching letters instead of reading letters if a child is too young to read. Colourful lights can also ensure young children’s eyes are aligned and working together, and instruments can check the eye is healthy at the front and back. Optometrists are trained in testing children’s eyes as much as adults, so the test results are just as accurate in children.

An eye test being conducted on a child by an optometrist.

Visiting an Optometrist

A referral from your GP isn’t required for an adult or child to see an optometrist. But if you aren’t sure about which optometrist to visit or you have any concerns about your child’s eyesight, a visit to the GP is a good idea. 

For young children, it’s best to make the appointment in the morning or after their daily nap so they aren’t tired. 

For those who have a Medicare card, most eye tests are free through Medicare and therefore bulk-billed. Children are eligible for one bulk-billed test every three years, or more frequently if they have eye conditions. However, Medicare doesn’t cover the costs of glasses or contact lenses. Optical cover is included in most Extras cover so if you have a family policy, you can claim for the cost of your child’s glasses or contact lenses.

Even if there are no issues or concerns, it’s best to take your child to the optometrist for a regular eye check up every two years to ensure an eye problem hasn’t developed. For those children who have an eye issue that can change rapidly, their optometrist can see them as often as monthly.

A little girl and her mum picking out a pair of glasses after her eye test.

Signs to Watch out For 

Young children can’t tell their parents if they’re experiencing a problem with their eyesight. They either can’t communicate or more likely don’t know any different. It’s important parents know the clues to look out for such as:

  • Frequent blinking or squinting

  • Holding their head to one side

  • Regular eye rubbing or complaining of tired eyes

  • Struggling to read 

  • Discomfort from blurry, watery or itchy eyes 

  • Headaches or migraines

  • Light sensitivity

  • A turned or misdirected eye

  • Sitting close to the TV or holding a book close to their face

Vision problems are often picked up by teachers in the classroom or parents helping with homework because most of these activities rely on good eyesight. Speak to your child’s teacher and ask if they have noticed any of the following:

  • Difficulty seeing the board

  • Struggling to do in-class activities or homework

  • Poor concentration

  • Poor handwriting

A young girl receiving an eye test from an optometrist.

Common Eye Problems in Children

When people think of eyesight problems, they usually think of long-sightedness, short-sightedness and maybe astigmatisms, but there are other problems to be aware of. 
 

Short-sightedness

Children who are short-sighted see blurry objects in the distance. Short-sightedness often occurs during puberty. Known as myopia, short-sightedness is the most common vision problem for under 40s. Symptoms include squinting, eye strain and headaches. There may be a higher risk in children whose parents are also short-sighted. 

Myopia occurs when the cornea is too curved for the length of the eyeball or the eyeball is too long, relative to the focusing power of the cornea and lens. Shortsightedness often stabilises in adulthood but can continue to progress. 

Glasses or contact lenses may be needed all the time or only when focusing on objects in the distance. 
 

Long-sightedness

Someone with hyperopia (long sightedness) can usually see objects clearly in the distance but struggles seeing or focusing on objects that are up close. They can suffer from symptoms such as headaches or eye strain. Many children grow out of long-sightedness. International studies show 8.4% of six year old children have hyperopia which falls to 2-3% of children aged six to nine years and around 1% of 15 year old children.

Long sightedness in adults over the age of 40 is known as presbyopia and is different to hyperopia. 

Glasses or contact lenses can change the way the light is refracted into the eyes.

A school aged boy wearing glasses and doing homework at the kitchen table.

Astigmatism

Astigmatism is a refractive error caused by irregularities in the shape of the cornea. It happens when the eye fails to focus the light equally on the retina causing blurred or distorted vision. An astigmatism can be present at the time of birth, or can develop gradually over a lifetime. Most astigmatisms can be corrected with glasses or contact lenses. Surgery is less common due to the associated risks.  

There are three main kinds of astigmatisms:
 

Myopic Astigmatism

As the name suggests this astigmatism occurs when it’s combined with near-sightedness. The two curves are focused in front of the retina. 
 

Hyperopic Astigmatism

Hyperopic astigmatism occurs when astigmatism is combined with far-sightedness and the two curves are focused behind the retina.
 

Mixed Astigmatism

Mixed astigmatism occurs when the cornea produces both myopia and hyperopia.

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Amblyopia

Around 1 in 50 children have amblyopia. Also known as a lazy eye, one eye is weaker than the other, so a child relies more on their good eye. It may be diagnosed at a development screening or during an eye test by the age of four. Glasses can be used to correct the weaker eye but if it doesn’t respond, a patch may need to be worn over the good eye to force the weak eye to work harder.  
 

Squint

A squint is when the eyes point in different directions causing blurred vision, double vision and may lead to a lazy eye. Around 1 in 20 children have a squint, usually occurring before the age of five. Most of the time this  is picked up in routine eye checks. 
 

Colour Blindness

Colour blindness is a condition that makes it hard to pick out the red, yellow and green parts of the spectrum. It can be difficult to diagnose in children under the age of four but by this age a parent or teacher may notice a child struggling to name or separate items by colour. Colour blindness can be genetic or caused by a brain injury, eye diseases such as macular degeneration, glaucoma and diabetic retinopathy, or a vitamin A deficiency. One in 20 males are impacted and fewer numbers of females.  

After the eye test, the optometrist will advise you if your child needs glasses. Depending on the optometrist you visit, your child may be fitted for glasses at the same retail location or you may need to take a prescription to an optician who will supply the glasses or contact lenses. 

For eye injuries or optical medical conditions an optometrist may refer your child to an ophthalmologist.

A school aged boy wearing glasses and doing homework at the kitchen table.

Tips for Protecting Your Child’s Eyesight

As parents there are a few things you can do to ensure your child’s eyes stay healthy.

  • Limit screen time as it can cause dry eyes, eye strain and blurred vision

  • Encourage your child to wear a hat and sunglasses when in harsh sunlight

  • Protect your child’s eyes from potential injuries from paint, chemicals and sharp objects

  • Ask your child to read to you throughout their primary school years

  • Look out for signs and symptoms of eye problems 

  • Take your child to an optometrist for an eye check every two years or sooner if you have concerns.

For more information on which policies include optical benefits, see our Optical Cover page. Be sure to also check out the online and in-store optical discounts available only to HIF customers.  

Tammy George

Please note: Tammy's blog is general advice only. For further information on this topic please consult your healthcare professional.

Category:Optical Health, Eye Health

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