Free eye checks are offered to newborn babies and young children. These will show if there are any problems early on.
Why eye checks are important
Children may not realise they have an eye or eyesight problem. The sooner an eye problem is found, the sooner your child will get treatment and support.
Your child will have routine or scheduled tests to check their eyesight. Make sure your child attends these eyesight tests.
If an eyesight problem is not detected, it may affect their development and education.
If you are worried about your child's eyesight between scheduled tests, talk to your GP or public health nurse (PHN). They can refer your child for a further appointment.
You may also bring your child to an optometrist at an opticians for an assessment. An optometrist diagnoses and treats common eye conditions. There is usually a fee for this service.
When your child's eyes are checked
Your child's eyes may be checked a number of times throughout the first hours, weeks and years of their life.
Within 72 hours of birth
A paediatrician or specialist midwife will check your baby's eyes within 72 hours of birth. This is part of the newborn health examination.
Between 6 and 8 weeks old
This is a follow-up examination with your GP to check for any obvious problems that were not picked up soon after birth.
Between ages 4 and 5
Your child's eyes will be checked at school in junior infants. This is called eyesight screening. It checks for reduced vision in 1 or both eyes. Screening aims to find problems early so that treatment can be given if needed.
Your school PHN does the screening at school.
Eyesight screening in junior infants
After junior infants
Contact your GP if you think your child may have a problem with their eyesight.
Children can have an eyesight test at any age. They do not need to be able to read, or even speak.
Spotting signs of an eye problem
Types of eye problems in babies and children
There are different types of eye problems that can affect children.
These include:
- cataracts - cloudy patches in the lens of the eye, that you may be born with
- amblyopia (lazy eye) - their eyesight does not develop properly, usually in 1 eye
- strabismus (squint) - the eyes look in different directions
- myopia (short-sightedness) - distant objects appear blurred
- hyperopia (long-sightedness) - distant vision is better than near vision
- astigmatism - the transparent layer at the front of the eye (cornea) is not perfectly curved
- colour vision deficiency (colour blindness) - difficulty seeing colours or the differences between colours
Types of eye tests
A number of tests may be done to check for eyesight or eye problems.
The red reflex test
The red reflex test is usually done as part of your newborn's health checks.
Your doctor, specialist midwife, PHN or optometrist uses a tool called an ophthalmoscope for this test. The tool magnifies the eyes and uses a light so they can be examined clearly.
When light is shone into your baby's eyes, a red reflection should be seen as it's reflected back. If a white reflection is seen, it could be a sign of an eye problem.
The pupil reflex test
Your doctor, specialist midwife, PHN or optometrist shines a light into each of your baby's eyes. This is to check how their pupils (black dots at the centre of the eyes) react to light.
Your baby's pupils should automatically get small in response to the light. If they do not, it could be a sign of a problem.
Attention to visual objects
This is a simple test to check whether a newborn baby pays attention to visual objects.
Your doctor or specialist midwife will try to attract your baby's attention with an interesting object. They then move it to see if the child's eyes follow.
These sorts of tests can also be used to check the eyesight of older babies and young children who are not yet able to speak.
If your child can speak but is not yet able to recognise letters, pictures may be used instead of objects.
Snellen and LogMAR charts
When your child can recognise or match letters, their vision is tested using Snellen or LogMAR charts. These charts have rows of letters and numbers that change in size.
Your child will be asked to read out or match the letters they can see from a specific distance.
For younger children, a similar test using pictures or symbols may be carried out instead.
Range of movement tests
These tests can check the range of movement of each eye. A child's attention will be drawn to an interesting object. This is then moved to different positions, for example, up, down, left and right.
This tests how well the eye muscles work.
Refraction test
A refraction test is carried out by an optometrist at an opticians. It is used to check if your child needs glasses and what prescription they need.
Before the test, your child may be given special eyedrops that widen their pupils. This is so the back of their eyes can be examined more clearly.
Your child will be asked to look at a light, or read letters on a chart using different lenses. If they do not know all the letters yet, they may match letters or pictures on a chart.
Colour vision deficiency (colour blindness) test
You may not notice your child has a problem with colour vision until they are older. But it can start at any age. It is more common in boys, and it can run in families.
Your child may be given a colour blindness test.
One of the tests used to check for colour blindness is the Ishihara test. This involves looking at images made up of dots in 2 different colours. If a child's colour vision is normal, they will be able to recognise a letter or number within the image.
If a child cannot tell the difference between 2 colours, they will not be able to see the number or letter on the test. This may mean they have a colour vision problem.