4401 Martin Luther King Blvd
Houston, Texas 77204

(713) 743-2020 | Monday - Friday 8AM -6PM

When should my child have their first vision examination?

Parents may be surprised to learn that many aspects of their infant’s vision function can be evaluated.  The pediatric optometrists in the Pediatric and Binocular Vision Service have extensive experience evaluating the vision of infants and young children including expertise in the specialized objective techniques necessary to test  your non-verbal child or those with limited verbal abilities. A child is never too young for a complete vision examination.

The early identification of vision problems is important. Undetected vision problems can delay a child’s development and late diagnosis may lead to permanent vision loss or a poorer prognosis for resolution of the vision problem. To maximize your child’s visual potential and development, the pediatric optometrists in the Pediatric and Binocular Vision Service recommend an infant’s first vision examination occur:

  • At 9 months of age if the parent or pediatrician do not have any concerns regarding a possible vision problem
  • As young as 3 months of age
    • If a family member has been diagnosed with amblyopia or strabismus (“eye turn”).
    • Child has strabismus that occurs only part of time but is still present at 3 months of age
    • Born prematurely
    • At-risk for or diagnosed with delayed development. Vision problems are very common in young children with Down Syndrome and Cerebral Palsy, including large amounts of refractive error (hyperopia, astigmatism, myopia), strabismus and focusing difficulties.
    • Any other condition that places your child at increased risk for vision problems
  • Immediately if the infant has
    • Strabismus that is present all the time
    • White pupil
    • Abnormal appearing eye
    • You or your pediatrician believe your child has a significant vision problem

What to Expect

A complete vision examination includes:

  • Questions about your child’s vision, development and general medical health and your family’s eye and general medical history.
  • Visual Acuity (clarity of vision) utilizing one or more of the following tests:
    • Preferential looking- Infants and toddlers like to look at patterns. This technique takes advantage of this preference and allows the doctor to formally measure vision and assign a value, e.g. 20/100
      • Teller Acuity Cards and Cardiff Cards are frequently used
  • Pictures or tests with limited numbers of letters
    • Between 2 and 3 years of age, preschoolers are able to respond to tests using pictures or a limited number of letters if a child is allowed to respond by matching rather than naming the test symbols.
    • A  computerized acuity testing device or Lea Cards is most often used in our clinic
  • This testing aids in diagnosing amblyopia and is important to test during amblyopia treatment
  • Eye Coordination , alignment and focusing
    • This testing detects strabismus, eye coordination and movement problems and focusing anomalies
  • Eye drops to dilate the eyes. These aid assessing the following areas.
  • Refractive error (excessive hyperopia, astigmatism, myopia)
  • Eye Health


A vision examination may also include:

  • Color vision assessment
  • Measurement of intraocular pressure (pressure in the eye)
  • Screening of general development or assessment of visual and auditory perceptual skills (spatial and phonological awareness)
  • Specialized additional testing to diagnosis
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