If toddlers are too young to identify letters or pictures on an eye chart, how will parents know if they need glasses?

Routine checkups at the pediatrician’s office frequently include a vision screening procedure that takes a photograph of the child’s eyes. Analysis of the result can give the doctor useful information about whether the child needs to wear glasses, says Dr. Steven Rubin, co-chief of pediatric ophthalmology at Northwell Health.

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Between screenings, Rubin offers this advice:

  • Whether a toddler gets right up close to the television isn’t always a reliable gauge in itself of a child’s eyesight, Rubin says. Toddlers tend to get close to the TV so that it takes up most of their field of vision and to avoid peripheral distractions, he says. What’s more telling is whether, after Mom or Dad pulls the child back, the toddler keeps walking up to the screen.
  • Likewise, most toddlers also like to hold books close to their faces, even if they aren’t extremely nearsighted, Rubin says. So that isn’t a surefire measure either, he says.
  • What Rubin recommends looking out for is frequent squinting. “When the child squints, he is looking through a narrower opening and can see more clearly,” Rubin says.

If parents suspect a problem, Rubin recommends toddlers be taken to a pediatric ophthalmologist, who has medical training and will always dilate the child’s pupils to rule out any eye diseases that can cause reduced vision. The doctor can then use an instrument called a retinoscope to examine the child’s eyes and determine the prescription needed, Rubin says. “A child doesn’t need to be verbal in order to get a prescription,” he says.