When should a child have their first eye test?
By See Better · Updated · 5 min read
The short answer
Children should have a first eye check as a baby, between 6 and 12 months, again at around 3 years, and a full eye test before they start Grade 1. After that, test every one to two years. A child does not need to know letters or be able to read to have an eye test.
Key points
- Aim for checks at 6 to 12 months, around 3 years, and before Grade 1.
- Children's tests use pictures, shapes and lights, so reading is not needed.
- Most vision problems in children are easier to treat the earlier they are found.
- A school vision screening does not replace a full eye test.
Why early eye tests matter
A child's vision is not finished at birth. The eyes and the brain learn to see together over the first seven or eight years of life. If one eye sends a blurry or misaligned picture during that time, the brain can learn to ignore it, and the eye may never develop full vision. This is called a lazy eye, and it is far easier to treat at 4 than at 10.
Children almost never tell you that something is wrong. They have no way of knowing that other people see differently. A child who has always seen a blurry board assumes that is what a board looks like. Regular tests are the only reliable way to find out.
The eye test timeline
| Age | What to do |
|---|---|
| Newborn | A doctor or nurse checks the eyes soon after birth and at the first clinic visits |
| 6 to 12 months | A first eye check, especially if eye problems run in the family |
| Around 3 years | A check for focusing problems, squints and lazy eye |
| 5 to 6 years | A full eye test before starting Grade 1 |
| School years | Every one to two years, or as the optometrist advises |
Reasons to test sooner
Do not wait for the next age on the table if:
- a parent, brother or sister had a squint, a lazy eye or strong glasses as a child
- your child was born prematurely or had a low birth weight
- one eye turns in, out, up or down, even now and then
- your child tilts their head, covers one eye or sits very close to the TV
- you notice a white or unusual reflection in the pupil in photographs
- your child has a developmental delay or a condition such as Down syndrome
Signs your child needs glasses has a fuller list of what to watch for.
A white, grey or yellowish glow in a child's pupil, a new squint or an eye that suddenly turns should be seen by a doctor promptly. They are sometimes signs of a serious eye condition.
What happens in a child's eye test
A children's eye test is designed around what a child can do at their age. Nobody expects a three-year-old to read letters.
- Babies and toddlers: the optometrist watches how the eyes follow a light or a toy, checks that they move together, and uses a light and lenses to estimate the prescription without the child saying a word.
- Preschoolers: pictures, shapes and matching games replace the letter chart.
- School-age children: the test looks much like an adult's, with letters, a check of focusing and eye teamwork, and an examination of the health of the eyes.
The test does not hurt. Sometimes eye drops are used to relax the focusing muscles and get an accurate measurement. They can sting for a few seconds and leave near vision blurry for a few hours.
Is a school screening enough?
No. A screening at school or at a clinic is a quick check, usually of distance vision only. It is useful for catching obvious short-sightedness, but it can miss long-sightedness, astigmatism, focusing problems and eyes that do not work well together. Those are the problems that make reading tiring. A child can pass a screening and still struggle with schoolwork because of their eyes. See can poor eyesight affect school performance?
How to prepare your child
- Choose a time when your child is rested and fed, not just before a nap.
- Explain that someone is going to look at their eyes and play some looking games, and that nothing will hurt.
- Bring any glasses they already have.
- Write down what you have noticed and any family history of eye problems.
- Stay calm and matter-of-fact. Children take their cue from you.
Having the test at home
Many children are more relaxed in their own lounge than in a clinic. See Better brings the eye test to your home anywhere in Gauteng, and the whole family can be tested in one visit. An eye test costs R450. Tell us your child's age when you book on WhatsApp so that we can plan the visit.
Frequently asked questions
Can a toddler have an eye test if they cannot read?
Yes. Optometrists use lights, toys, pictures and shapes to test young children, and they can measure a prescription without the child having to answer any questions.
How often should children have their eyes tested?
Every one to two years through the school years, and more often if they wear glasses or if the optometrist is monitoring something. Children's eyes change quickly while they grow.
Does my child need an eye test before starting school?
Yes. A full eye test before Grade 1 is strongly recommended. Seeing the board, reading and writing all depend on good vision, and problems are easier to correct before a child falls behind.
My child seems to see well. Do they still need a test?
Yes. Children adapt remarkably well and seldom complain. One eye can be doing all the work while the other is weak, and neither you nor your child would notice without a test.
This article is general information and is not a diagnosis or a substitute for an eye examination. If you are worried about your eyes or your sight, see an optometrist or a doctor. Sudden loss of vision, eye injuries and severe eye pain are emergencies.
