Good vision is an essential element of early learning development. The AOA reports that 1 in 5 preschoolers have vision problems and will need correction when they enter school. But according to the College of Optometrist in Vision Development; schools provide under 4 percent of the school-age vision screening test. They report that school screenings miss up to 75 percent of children with vision problems, and 61 percent of children with eye problems discovered through school screenings never go to the doctor for follow up. When a child grows up with undiagnosed vision problems, they adapt to this abnormal way of seeing. Not realizing that their vision is abnormal, they don’t seek help. The consequence is impaired learning development and years struggling in school. They arrive at adulthood with the same vision problems and often the same learning problems. Early intervention is vital as a child’s visual system becomes less adaptable as they become older. Leonard Press, OD, states, “Many bright children achieve below their level of competency because they are limited by their vision issues and could benefit from an annual comprehensive eye exam.” As with so many things in life, we have better results when we start young.

The American Optometric Association (AOA) convened an expert panel to develop new evidence-based guidelines that recommend annual comprehensive eye exams for children.

The panel concludes that there is an epidemic of undiagnosed eye and vision problems among children, and that routine school screenings are not enough. The panel recommends annual comprehensive exams by an optometrist who can diagnose and treat a range of conditions that routine vision screenings miss. They recommend that annual exams include tests specifically designed to detect eye and vision problems at each stage of a child’s life.


Some key milestones in eye development from the AOA include:

  • Infants should receive a comprehensive baseline eye exam between the ages of 6 and 12 months, immediately after the critical period when the eye undergoes rapid and profound changes and is therefore, most vulnerable to interference with normal development.
  • Preschoolers should receive at least one in-person comprehensive eye exam between the ages of 3 and 5 to prevent or diagnose any condition that may have long-term effects.
  • School-aged children (6 to 18 years) should receive a comprehensive exam before entering the first grade and annually thereafter.

Deborah Kotob
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