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Vision problems of preschool children

Preschool girl wearing eyeglasses while painting

During the preschool years from ages 3 to 5, your child will be fine-tuning the vision and visual skills he already has developed during the infant and toddler years.

Preschool vision tasks vary with a child's age and activities. For example, many young preschoolers are learning to ride tricycles and master the complex eye-hand coordination needed to pedal, steer and watch where they're going at the same time.

Older preschoolers are learning how to integrate vision and body motions (motor skills) by playing sports such as T-ball and soccer (keep your eye on the ball!), and working on the fine motor skills needed to write their names.

Warning signs of vision problems in children

If you have children between the ages of 3 and 5, be aware of these warning signs of possible preschool vision problems:

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Timely eye exams help ensure your preschooler's vision is developing properly.

  • Consistently sitting too close to the TV or holding a book too close

  • Squinting

  • Tilting the head to see better

  • Frequently rubbing eyes, even when not sleepy

  • Shielding their eyes

  • Excessive tearing

  • Closing one eye to read, watch TV or see better

  • Avoiding activities that require near vision, such as coloring or reading, or distance vision, such as playing ball or tag

  • Complaining of headaches or tired eyes

  • Clumsiness, such as frequent tripping and bumping into things

IS YOUR CHILD EXHIBITING ANY SIGNS OF VISION PROBLEMS? Find an eye doctor near you and schedule an eye exam for your child.

Refractive errors

The most common preschool vision problems are refractive errors:

  • Nearsightedness (myopia) is another common preschool vision problem. Myopia causes distant objects to be blurry, such as letters or numbers on a classroom wall.

  • Astigmatism causes blurry or distorted vision at all distances.

Refractive errors affecting young children typically can be fully corrected with eyeglasses.

Your child's first eye exam

Even if your child exhibits no symptoms of a refractive error or other preschool vision problem, he or she should have an eye exam by the age of 6 months, again at age 3, and also prior to starting school.

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Academic performance and children’s vision are inextricably linked. Experts say that up to 80% of all learning occurs visually, leaving kids with poor vision at a major disadvantage.

Having a complete eye exam before your child enters school allows enough time to catch and correct any vision problems that may interfere with their learning.

The goal of your child's preschool eye exam: Your child won't be one of more than 12.1 million school-age children in the U.S. who have some form of vision problem.

In a handful of states, your child may be required to have a comprehensive eye exam before entering school. Several other states have pending children's vision policies or legislation requiring an eye exam after a child fails a vision screening.

What is your state's policy on eye exams before your child enters school? Vision Impact Institute tracks state policies covering preschool eye exams as part of Kids See: Success, an initiative created to advocate for children to get eye exams before they enter kindergarten.

Children who need vision correction because of refractive errors should have annual eye exams throughout their school years to evaluate any changes.

Eye exams vs. vision screenings

During preschool and the school years, your child's visual system is developing along with the rest of her body, so annual eyeglass prescription changes are common.

Make sure your child receives a comprehensive eye exam from an eye doctor, not just vision screenings from school nurses or pediatricians.

Vision screenings may help spot problems, but they can miss them too. Why? Vision screenings are not comprehensive, and they typically are administered by people who are not trained to detect and diagnose all vision and eye health problems.

Comprehensive eye exams are performed by an eye care professional.

Tips for a successful eye exam for your child

Schedule the eye exam and glasses selection at a time that's good for your child. As you know, some children are more focused early in the day, while others come to life after lunch or an afternoon nap.

Don't plan a visit to the eye doctor when your child is typically tired, cranky or hungry.

If your child needs glasses, make the process fun

If your child needs eyeglasses, get him or her involved in selecting them. If your child helps choose the frame, he or she will be more motivated to wear the glasses.

Also, explain the benefits of the glasses, using specific examples — such as, "Your new glasses will help you see the ball better when you play catch."

When choosing frames, select a few styles for your child with the help of an experienced optician. (See our article on 10 tips for choosing children's glasses that last.) Then give your child the final choice of the glasses he or she will wear.

Make the selection process a positive event, discussing how lots of people he or she knows wear glasses, and how they see much better.

Make sure the frames you choose are fitted properly for your child and are comfortable. No one, especially a child, will wear uncomfortable glasses.

READY TO SHOP FOR GLASSES FOR YOUR CHILD? Shop for children's glasses at an optical store near you or at an online eyewear retailer.

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Gary Heiting, OD

Gary Heiting, OD, is a former senior editor of AllAboutVision.com. Dr. Heiting has more than 30 years of experience as an eye care provider, health educator and consultant to the eyewear ... Read more