Serious vision problems in childhood are rare, but routine checks help catch issues early
Free NHS sight tests are available for children under 16, and under 19 in full-time education
Children may not realise they have a vision problem themselves
Eyes are checked several times from birth through school age
See a GP or optician anytime you have concerns about your child's vision
Why Eye Checks Matter
Although serious vision problems in childhood are rare, routine eye checks are offered to newborns and young children to help catch any issues early. Children often don't realise they have a vision problem, so without routine testing, a problem could go unnoticed and potentially affect their development and education. Free NHS sight tests are available at opticians for children under 16, and for those under 19 in full-time education.
When Checks Happen
A child's eyes are typically checked several times through infancy and childhood. Within 72 hours of birth, eyes are checked for obvious physical problems as part of the newborn physical examination, followed by a repeat check between 6 and 8 weeks old. Around age 1, or between 2 and 2 and a half, parents may be asked about any concerns as part of routine child health reviews, with further testing arranged if needed.
Around age 4 or 5, soon after starting school, children are often given vision screening to check for reduced vision in one or both eyes — though this isn't offered in every area. If your child's vision isn't checked at school, it's worth taking them to a local optician instead. It's fine to speak to a GP or optician about any concerns at any stage, regardless of the routine schedule.
Page last reviewed: 6 March 2024 · Next review due: 6 March 2027
Eye Tests · Testing
What Tests May Be Carried Out
? 5 min readReviewed: March 2024
Tests for Babies
The red reflex test, done as part of newborn checks, uses an instrument called an ophthalmoscope to examine the eyes closely — a red reflection when light is shone in is normal, while a white reflection could suggest a problem. The pupil reflex test checks whether the pupils shrink normally in response to light. For babies who can't yet speak, attention to visual objects can be tested by attracting their gaze with an interesting object and watching whether their eyes follow it — a similar approach using pictures can be used for children who can speak but not yet recognise letters.
Tests for Older Children
Once a child can recognise or match letters, vision is tested using Snellen or LogMAR charts, with rows of letters or numbers in decreasing sizes read out from a set distance — pictures or symbols can be used instead for younger children. Range of movement tests check how well the eye muscles work, by tracking an object moved to eight different positions around the field of vision.
A refraction test, carried out by an optometrist at a high-street opticians, checks whether glasses are needed and what prescription would help — this sometimes involves eyedrops to widen the pupils first, followed by different lenses tested in front of the eyes. Colour vision deficiency tests, such as the Ishihara test using coloured dot patterns, are usually used in older children if a colour vision problem is suspected.
Page last reviewed: 6 March 2024 · Next review due: 6 March 2027
Eye Tests · Warning Signs
Common Eye Problems and Signs to Watch For
? 5 min readReviewed: March 2024
Conditions Eye Tests Can Detect
Eye tests can help identify a range of conditions, including childhood cataracts (cloudy patches in the lens present from birth), lazy eye (where vision in one eye doesn't develop properly), squint (where the eyes look in different directions), short-sightedness, long-sightedness, astigmatism, and colour vision deficiency, which is more common in boys.
Signs Worth Watching For
For babies, the checklist in the personal child health record (red book) can help you track normal visual development. In older children, possible signs of an eye problem include the eyes not pointing in the same direction, complaining of headaches or eye strain, difficulty reading (such as holding books close or losing their place), poor hand-eye coordination or struggling with ball games, unusual clumsiness, frequently rubbing the eyes, or sitting too close to the TV.
Speak to a GP or visit an optician if you have any concerns about your child's eyes or vision — children can have an eye test at any age, and don't need to be able to read or even speak. It's particularly worth arranging a test if there's a family history of childhood eye problems, such as squint or lazy eye.
Page last reviewed: 6 March 2024 · Next review due: 6 March 2027
