Your baby’s first eye exam will likely occur before your baby even leaves the hospital, according to guidelines from the American Academy of Pediatrics (AAP). During these screenings, the doctor will be looking for signs that your baby’s eyes are functioning correctly and there is no problem with the eye muscles or structures in the eye.
One important test performed on infants is called the red reflex text. During this test, the doctor shines a light in your infant’s eyes. In normal eyes, the light is reflected off the back of the eye, producing a red reflection when the doctor looks in the eye. If something blocks the reflection, such as cataracts, glaucoma, or a retinoblastoma (the most common eye tumor in children), the red reflex is not present and the test is considered abnormal. Further tests would be ordered, and your infant would likely be seen by an ophthalmologist before leaving the hospital to determine the cause.
Infants who fall in a high-risk category, such as a family history of retinoblastoma or glaucoma, will likely be seen by an ophthalmologist to undergo additional screenings even if they have a normal red reflex—again, often before your baby leaves the nursery. The American Academy of Ophthalmology also recommends additional screening if your baby shows any signs of developmental delays over the coming months.
As your baby grows, the pediatrician will continue to check the red reflex at every visit. The doctor will also begin to check for normal eye muscle movements, equally round pupils, and crossed eyes (also known as strabismus). When your child can cooperate with a true vision test (between 2.5 and 3.5 years of age), visual acuity should be checked. By 5 years old (school age), it is important to have a formal visual acuity test done so that schoolwork will not be affected by poor vision.
Reviewed by Dr. Sara Connolly, August 2019
- It is important to have a visual acuity check before school age.
- Your baby will be checked to make sure a red reflex is present in both eyes before leaving the hospital after birth.
- In infants, doctors are looking at general eye health and eye coordination and movement.
- Make sure your child has a true vision test when they are 2.5-3.5 years old.