Last updated on September 10, 2021.
Vision is a crucial part of learning and developing as children grow and explore their world. A child’s visual system grows and develops from being able to see in fuzzy black and white as a newborn to fully mature at the age of eight. So, at what age should children first visit an eye expert and which eye care providers should they be seeing? We spoke to optometrist Cecilia Wong 黃詩慧 from PolyVision Eyecare (Tsim Sha Tsui) Centre about the importance of eye exams in young kids and the availability of providers in Hong Kong.
Importance of eye examination in children
Sight abnormalities may affect children’s future visual development and can cause irreversible damage. This is particularly important in Hong Kong where 61.5% of 12 years-old children were found to have myopia (shortsightedness) in a study conducted by the Hong Kong Polytechnic University. Vision problems can prevent children from social activities, and participating and succeeding at school. Kids may not realize they have sight issues, and if their eyes aren’t tested regularly, problems could go undiagnosed for months or years. Caught early, these issues are easily preventable. In fact, vision problems are much easier to treat when the child’s vision is still developing — up to 7 or 8 years old.
Early signs that your child may have eye problems
It can be difficult for parents to catch vision problems as children usually adapt to them as they grow. Early signs parents and caregivers may pick up on include:
- Complaints of headaches
- Frequent blinking or rubbing of the eyes
- Tilting the head or squinting to see properly
- Covering one eye when reading or watching television and computer screens
- Poor hand-eye coordination
- Inability to see far away or close up
- Red or watery eyes
- Complaints of blurred or double vision
- Leaving out or confusing words when reading
- Holding reading materials very close to their eyes
Age at which children should have their first eye test
Children should have a comprehensive eye examination by an optometrist when they have turned four. At four, children are generally able to follow the required instructions to undergo their vision test. However, if they have any of the early signs mentioned above or are significantly behind in their development, consult your pediatrician or GP.
Recommended frequency of an eye examination for children
After their first eye exam at age 4, children should have at least one comprehensive eye exam just before they enter primary school. Children are also recommended to have an annual eye exam to ensure normal visual development and catch or monitor any eye disorders. Good vision is crucial for their educational and general development. With regular eye examinations, optometrists can help children to achieve their best possible vision.
What parents can expect at their children’s eye examination
- Vision and refractive status – Examples of detectable conditions include: myopia, astigmatism, hyperopia, lazy eye
- Binocular vision – Examples of detectable conditions include: eye turn, visual tracking problems
- Color vision screening – Examples of detectable conditions include: inherited color vision deficiency
- Ocular health – Examples of detectable conditions include: pediatric cataract, pediatric glaucoma
- Fundus / Retinal photography – Examples of detectable conditions include: toxoplasmosis, retinopathy of prematurity
- Diagnosis and recommendation – Examples include optical prescriptions for dispensing spectacles, vision training exercises for eye turn
Public eye care providers for children
Your local Maternal and Child Health Centres offer free pre-school vision screening for kids four years and older with an optometrist or orthoptist. A comprehensive list of MCHCs can be found here.
If your child is close to or over four years old and is registered with an MCHC, contact the MCHC or call the Pre-School Vision Screening phone booking system at 3793 6111. If your child is over four years old and is not registered with an MCHC, check the Family Health Services website or call 2112 9900 for details about making an appointment for registration.
It is important to note that public pre-school vision screening has a long waiting time and does not test for refractive errors (i.e., hyperopia, myopia, astigmatism) in detail, color vision deficiency and other specific eye diseases such as glaucoma retinal diseases. Like any other screening test, vision screening cannot detect all visual problems. If a child passes their eye test, it means that the child has a relatively low chance of having a lazy eye and/or significant refractive error. If you suspect an eye issue or your child reports visual problems at school or in daily activities, it’s recommended that your child sees a private optometrist for more thorough screening.
Private eye care providers for children
Parents should bring their children to consult an optometrist for a comprehensive eye exam if a visual problem, such as acquiring myopia, is suspected. The optometrist will perform a refraction test and detect for any other eye health conditions. If the child has myopia, the optometrist will prescribe appropriate glasses and provide suggestions to control further development of the issue. Parents should bring their children to consult an ophthalmologist for medical or surgical treatment if a medical problem in the eye is suspected, such as getting a painful and swollen sty on the eyelid that does not go away after being treated by the GP.
Optometrists and ophthalmologists are both eye care professionals. In Hong Kong, optometrists who are registered as Part I category under the Optometrists Board have received university-level training.
Optometrists are primary care providers for vision and eye problems and are qualified to provide comprehensive eye examinations, use diagnostic drugs and prescribe optical aids. They provide refraction exams and dispense optical aids (e.g., spectacles and contact lenses) and detect, diagnose and manage eye diseases.
Ophthalmologists are medical doctors who are specialized in eye and vision care. Ophthalmologists are trained to perform eye examinations, diagnose and treat eye diseases, prescribe medications and perform eye surgery. A list of ophthalmologists registered in Hong Kong can be found on the Hong Kong specialist registry.
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