Eye Sight Assessment for Two Year Old

Updated on February 06, 2012
M.T. asks from Saint Paul, MN
8 answers


Today, I took my son (almost 2 year old 4 months) to an opthamologist for the first time. They dialated his eyes and a technician and the doctor looked at his eyes through lenses with and without light. Of course, my son cannot verbally tell them anything. The diagnosis that he received was very severe far sightedness, prescription of 5.5-6. I was surprised because we hadn't seen any sign that he was far sighted, except for him crossing his eyes one day a couple of weeks ago when he was running a fever. He loves to "read" books, etc.

This experience got me curious. How do they assess the eye sight of non-verbal young children? What are they looking for and how can they tell what prescription he should have?

Has any of you had your child receive a prescription at a young age (before s/he could verbally tell what s/he can see during assessment) and it turned out to be incorrect? Started wondering because he may be a bit warm today again (fever?) so I wonder if it could have affected the results. Also curious because I have no idea how they came up with the prescription (how reliabile can it be)?

This was a new experience for me (seeing how they assessed our son's eye sight and learning that he was far sighted). If anyone knows more about this please let me know. I'd like to hear others' experiences too.

Thank you!

Just to clarify, I never intended to NOT get glasses for him, incase some moms here were concerned. Actually, we're going today to get them. I just was curious how they determined the prescription and hoped that it was accurate. The reason we brought him in was because his eyes were crossed one day, and the doctor was happy that we caught him this early so his eye crossing won't get worse. No delaying getting glasses!

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answers from Kansas City on

That is a really good question, and I will be eager to read the responses of moms and dads that have been there. And I would wait to find out too, before I spent money on glasses for my 2 year old! I remember getting glasses when I was 4 years old though, and I do remember being able to see better.

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answers from Oklahoma City on

They look at the shape of the "hole" that allows the things we see to enter the processes of the eye. They look to see how it responds to the lights interaction, if it changes shape equally. They can tell a lot nowadays.

I think that if he wears his glasses and they seem to make a difference then he should wear them. If it doesn't matter I would not be frantic about making sure he had them on.

My grandson needed glasses and his dad didn't take him to the doc. His eyes were so bad his brain had stopped processing the information it was receiving from his right eye. He had to do exercises every night for a very long time. He is fine now, he only wears glasses when he does up close work like reading or computer stuff.

I would trust the doc then observe what happens.



answers from Minneapolis on

if your unsure-get a 2nd opinion..always..good luck



answers from Minneapolis on

I had the same question and just asked the Dr. as he was doing the exam. They are usually more than happy to explain it to you.

Like another mother said - the lens' that he/she is holding up to the child's eye is allowing them to see how the eye is reacting to light, movement, etc. and this is how they determine what prescription is needed.

It is a bit odd, but it's one of those things that you have to just go with. I got my daughter the glasses w/ the hooks on the ears - they are wonderful b/c they can't take them off. When she was little and didn't want to wear them i would tell her that her favorite stuffed animal wouldn't be able to recognize her w/ out her glasses and that kept them on. She's 5 now and got to pick out her first pair of 'big girl' glasses last summer. Target has some cool glasses for kids and a great warranty plan.

RE: not getting glasses, as another mother stated, when not working correctly they eye will stop communicating to the brain and it does shut down. BIG PROBLEM. Even w/ glasses for the last 3 years we're patching one of my daughters eyes to strengthen the other. Get the glasses now!



answers from Washington DC on

They can do assessments in infants. When I took my DD to the optometrist for the InfantSEE program, she said she can get a lot out of how the eye reacts to her doing things. The eye should do x if the object is close or y if the object is far. Most children start out far sighted and then become near sighted (it's actually partially cultural - friend of mine worked in Guatamala and nearly everyone was far sighted. She started working at a practice in a large US metropolitan area and everybody is near sighted).

My DD was not given corrective lenses, so I'm not sure how that works, but I could ask.

I asked my OD friend. She said "The technique is called retinoscopy. If you shine a light across the
eye (or any other lens system for that matter) the image moves if
there is power in the lens. Take your glasses off and look at a door
frame through them. If you move them back and forth you'll see that
the image of the door frame in your glasses seems to move faster than
you are moving the glasses. If you add the right power, you'd cancel
the power in your glasses and the effect would be cancelled.
Retinoscopy does the same thing to the eye."


answers from Eugene on

The eye doctor can't tell everything even if the child does talk. They can't tell if your child has depth perception.
Do your child a favor and get the glasses. He will wear them only part of the time anyway until he knows the world is clearer when they are on.



answers from Pittsburgh on

My son has had glasses since he was two years old (he is now eight). He was born with cateracts in both eyes; they were surgically removed at age two and artifical implants were put in. The doctors were unsure of how well he would see because they said for the first two years of his life his eyes had not been communicating properly with his brain due to the cataracts. They dialated and looked in his eyes and made a diagnosis. They gave him a prescription for eye glasses with bi-focals and he began wearing them after he healed up from surgery. They told me that his brain would be relearning how to see but that he would probably always have "low-vision".

Well years went by and they slowly began asking him to look at pictures and answers questions at his eye checkups in addition to just dialating and looking at them through various strange-looking hand-held lenses. He's been getting a new prescription for glasses every single year since then. One time they asked me if he had an IEP at school for his "low-vision" which really surprised me. We had never experienced any problems with him being able to see whatsoever! He can see things across the room, watch tv, read books with normal-size print, etc. Of course he cannot see as well without his glasses on. So I tried to tell them he didn't need an IEP at all. They tried to insist so I talked to his teachers and they all agreed that he didn't seem to need any special help to see...but they agreed to let him sit close to the front and get up to see things if he needed to.

Long story short...last year when he went for his yearly eye check-up they did the exam and reported that his vision was much better than previously thought. They were kind of shocked. More than one doctor came in to repeat the exam...same results his vision was much better than previously thought! I started to think that maybe they have been wrong all this time! Then I started to question how they can really tell what his vision is when he cannot tell them.

Well I'm not sorry I got him glasses and he absolutely does need them. But I don't know if they are 100% accurate at diagnosing his vision.



answers from Washington DC on

Does your insurance cover eyewear or a portion of it?
Yes, we are born farsighted, all the close up work we do starting in school trains our eyes to focus nearer and nearer. Eyes are muscles, they have to be used, near and far.

I would get the glasses. It is a disservice to him to allow him to "grow out of it". YOu can get the glasses with the hooks around the ears. ONce they start to wear them and they see they are not likely to rip them off.
If you child has poor eyesight and goes to school, things the other kids do easily he will not be able to do. Catching a ball, reading, walking a straight line.

Drs look at a variety of factors in assessing whether a 2 yo needs glasses like how the eye reacts to lights and different lenses. Until a child can say 1 is better than 2 that is how they decide what prescription to give. You will have to go back every 6 months or so while he grows. By school age he will be able to let you know which lens works best. And by then he should be on a yearly ophthalmologist visit, barring any unusual circumstances.

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