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Eye Exams in Pre-School Children

Cute Female Child With HandbagEye Exams in Pre-School Children: 2-5 Years Old

Children change rapidly as they grow. During the toddler and preschool years, children learn to recognize objects, colors, letters, numbers, and many other things in the world around them. Proper eye and vision development are essential for this learning. As they continue to grow, they develop the fine motor skills and hand-eye coordination necessary for coloring, writing, reading, and playing sports.

During these crucial formative years, up to 10% of preschoolers will develop a problem with their visual system. The most common issues are eye turns (strabismus) or focusing differences between the eyes (amblyopia). In many cases, these conditions are subtle and easily missed, but parents may notice their child squinting, rubbing their eyes, sitting too close to the tv, or avoiding things like coloring or drawing. The quicker these are treated, the higher the success rate.

Kentucky is one of only three states in the U.S. that require a comprehensive eye exam for children entering preschool or elementary school. This exam is different than the vision screenings done by local volunteers or pediatricians (which only check how well a child is seeing). The comprehensive exam is performed by an eye care professional who is trained to look for eye muscle problems, lazy eyes, focusing problems, eye health problems, and any other condition that could be affecting a child’s vision.

At Derby City Eye Care our preschool exams include the following:


This machine focuses light on the front of the eye to give the doctor an estimate of the child’s prescription and eye alignment

Patient History

The doctor will review any medications, allergies, health conditions, previous eye history, and family history of eye diseases.

Visual Acuity

During this part of the examination, the doctor evaluates how well the child is seeing far away and up close with each eye individually and with both eyes by asking the child to identify a series of pictures or letters on a chart.

Eye Muscle Assessment

Dr. Fowler will shine a light in the child’s eyes to make sure that their pupils are reacting properly. They will also ask the child to follow a moving object with their eyes to determine how well the muscles work individually and together.

Color Vision and Stereopsis

The doctor will ask the child to identify or trace several numbers in a book to check for any color vision deficiencies. They will also have the child put on some 3D glasses and identify different animals or shapes to assess their depth perception.


This is where the doctor determines whether the child needs glasses. They will do this by placing lenses in front of the child’s eyes and asking them to pick the one that gives them the clearest vision.

Anterior Eye Health Assessment

For this part of the examination, the doctor will evaluate the health of the child’s eyes with a light and magnifying lens. The doctor will move them around to get a detailed view of the eyelids, lashes, corneas, conjunctiva, irises, and lenses, to identify any eye conditions or diseases that may be affecting them.

Posterior Eye Health Assessment

We are almost done! Now our eye care specialist has to check the health of the retinas and optic nerves. Typically, this is done with a small, lighted hand-held instrument (called an ophthalmoscope). Occasionally, though, the doctor may need to put drops in the child’s eyes to enlarge (dilate) the pupils for a better view. The drops are harmless to the child and usually take 15-20 minutes to take effect. Then, Dr. Fowler will look into the child’s eyes with a special light that is attached to a headset (called a BIO) and check for signs of are any ocular diseases or eye conditions.

At the end of each eye exam our Crestwood optometrist will discuss his findings and recommendations, and answer any questions they have about their eye health. If the doctor does determine that the child has a vision problem, they may discuss several different therapeutic options such as eyeglasses or contact lenses, an eye patch, or vision therapy, depending on the condition, to help the student reach their full potential.