Many schools offer sporadic school screenings where students are asked to read a letter chart (measuring ‘visual acuity’) in an attempt to find those students that may be in need of corrective lenses. The problem is, reading a letter chart tells you very little about refractive error (near or farsightedness) and gives no indication of ocular health or risk factors for disease. A study published this fall in the journal Optometry found that having children simply read a letter chart catches less than 40% of ocular problems requiring special attention. It is true that a child with moderate to severe myopia (nearsightedness) will probably have difficulty reading the letter chart, but a child with moderate to severe hyperopia (farsightedness) will very likely be able to read even the smallest letters on the chart. Hyperopic patients have the ability to compensate for their refractive error by focusing the internal components of the eye, though this quickly results in fatigue (especially with near work).
At Vista Eye Care in Thornton Colorado, we recommend that a child’s first eye exam be at 6-12 months of age. This exam will allow us to determine if the child has a large refractive error which can be corrected to prevent amblyopia (“lazy eye”). The infant eye exam also allows us to determine if the eyes are developing normally, and to identify any early signs of muscle dysfunction, congenital cataracts, or eye turns. Your child’s next exam should be just before kindergarten begins. Exams should then follow once per year (unless your child is symptomatic between yearly check-ups) to monitor changes in refractive error, signs of ocular disease, and development of the eyes and vision. School screenings might help identify some extreme cases of poor vision, though they should not be relied on in lieu of an actual eye and vision examination.