Eye health: Your child's eye test

Babies have their eyes checked at birth and then at their six week check by their GP or health visitor. Your child’s eyes are next checked when they are four or five around the time they start primary school. Their eyes will be tested by the school nurse or orthoptist (an eye specialist). If you have any concerns about your child’s eyes between these checks, you should ask for advice from your health visitor, doctor or school nurse.

In the future, the NHS plans to give all children an eye test during their first year at primary school and this already happens in some parts of the country.

From the age of five, children can visit an optician for a free eye test. These tests are free up to the age of 16 and for full-time students under 19. According to the NHS it’s worth having regular eye checks at your local optician, even if you and your child are not aware of any problems.

How do I prepare my child for an eye test?

Make time to sit down and explain to your child what will happen during their eye test. Make sure your child knows that he or she will be asked to look at and identify objects for the eye doctor. These could be random pictures, letters or shapes of light on the wall. Also explain that the eye doctor may put drops in his or her eyes, but that it will not hurt.

What tests will be done on my child's eyes?

Babies are examined for any obvious problems such as cross-eyes, cloudiness (a sign of cataracts) and redness. A light is shone into the baby’s eyes to check pupil reflex. The midwife, or your doctor, will also check the baby pays attention and his or her eyes follow an object which is passed in front of them. An opthalmoscope (a magnifying instrument with a light on the end) is shone in the baby’s eye to check there is a red reflection. If the reflection is white the baby will be referred to a specialist who will check for signs of cataracts and other eye conditions.

When your child starts primary school at age four or five, charts with rows of letters of decreasing sizes will be held up and your child will be asked to read out as many of the letters as he or she can see. These are called Snellen charts or logMAR cards.
Your child will also be checked for the range of movement they have in each eye and how well their eyes follow a moving object.

Your child is usually not tested for colour-blindness until they are 11 or if a problem is suspected. Typically, the Ishihara colour vision tests will be used and involve images made up of two different colours of dots. If your child’s colour vision is normal, they will be able to recognise the letter or number that is highlighted. If they cannot tell the difference between two colours (such as red and green) and so cannot see the picture, they may have a colour vision problem.