University of Iowa Health Science Relations and
William Scott, MD
Professor Emeritus of Ophthalmology & Visual Science
First Published: November 2000
Last Revised: February 2004
Peer Review Status: Internally Peer Reviewed

Michelle, a fifth-grader, squinted to see the words on the chalk board at the front of the classroom. The teacher noticed her problem and had her vision screened by the school nurse, who sent a note home suggesting Michelle's parents have her vision checked.

Many schools screen students' vision, says Dr. William Scott, professor of pediatric ophthalmology at the University of Iowa College of Medicine. "Screening cannot take the place of a full eye exam, but it can help detect some vision problems, including poor vision, misalignment of the eye, 'lazy eye,' and other problems that could indicate a need for glasses."

If a problem is detected by the screener, then the child should have a complete visual exam to determine what kind of vision problem the child has, and whether vision correction is needed. An ophthalmologist will also examine the eyes for disease.

"When children are young, annual screenings are more practical than eye exams, which are expensive for parents and the health care system," Scott says. A full eye exam can cost $75 to $150, while free screenings are often sponsored by volunteer groups and at elementary schools.

The first few years of a child's life are critical in the development of good vision. A child's vision should be checked for conditions such as: misaligned eyes, cataracts, and problems that need correction with eyeglasses. These problems are not always evident by simply looking at a child. Each day that eye problems go undectected and untreated, a child's vision may deteriorate to the point of irreversibility. The earlier these conditions are detected, the more easily and successfully they can be treated.

Regular screenings are important because children tend to work around whatever vision problem they may have, often making it difficult for parents to notice potential problems. "If a child holds objects near his or her face, it may signal a vision problem. When reading, a child with normal vision should be able to read the book while it's in his or her lap," Scott says.

Another sign of trouble is when a child tilts his or her head or turns a certain way when looking at something. Parents of infants should check how well the baby follows faces, because fixing on and following a face is one of the earliest tests used to detect vision problems, Scott says.

If a child needs glasses, frame type doesn't matter, but lenses should be made of polycarbonate or plastic, Scott suggests. "These are safer and lighter than glass lenses. However, they do scratch more easily. Find an optical shop that specializes in durable children's frames and fitting the frames to the child's face correctly."

If you're thinking about contact lenses for your child, consider his or her maturity first, he suggests. "Parents could consider contact lenses for children in their early teens. It all depends on the level of responsibility the child is willing to accept. If he or she will clean the lenses each day and make sure they're put in appropriately, then contact lenses are a good option," Scott says.

For more information about children and vision correction, talk to your physician or ophthalmologist.