The Back To School Exam You May Be Forgetting

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The school year is coming up, and everyone wants to get off to the right start, but you may be overlooking an important exam in addition to your child’s back to school physical.

We contacted Dr. Inna Marcus, M.D. at the Virginia Eye Institute to tell us a little bit about the importance of getting an eye exam before starting school and a little bit of what to expect at your appointment.

Why are eye exams important before entering school?
It is important to identify vision problems before entering school for two reasons. The first is that poor vision can interfere with learning. Secondly, visual development occurs in early childhood and is completed in early adolescence. Visual development that is interrupted causes amblyopia, commonly called lazy eye. Amblyopia can be due to a need for glasses, the eyes are not aligned or something blocking vision like a cataract. Amblyopia responds best to treatment before age eight. Children with amblyopia who are diagnosed at an early age, preferably before starting school, have the best chance of improving their vision and having normal vision in both eyes throughout life.

How often and at what age should children get eye exams?
Screening for eye problems begins in the newborn nursery when children are screened by the the pediatrician for abnormalities caused by structural problems. This type of screening continues at well visits until age three when the visual acuity can be tested by having the child read an eye chart. Screenings should continue yearly throughout childhood. Any child who fails a screening, has suspected structural or eye movement problems, has medical problems associated with eye problems or has a family history of eye disease should be referred to an eye doctor for a complete exam.

What can parents and kids expect from a routine eye exam?vei pediatric eye care
A complete eye exam, sometimes called a routine eye exam, has five components.
1. Comprehensive history about any eye problems, medical problems and family history of eye problems.
2. Testing the visual acuity with an age appropriate method (ie. matching for younger children and lines of letters for older children).
3. Evaluation of depth perception and muscle balance including tracking and the ability of the eyes to work together.
4. Structural exam of the pupils, eye surface and inner structures including the lens, optic nerve and retina. The pupil must be dilated with special eye drops to allow the doctor to see the inner eye structures. This part of the exam can identify important problems like cataracts, retinoblastoma, coats disease and optic nerve problems.
5. Refraction which is the measurement of the glasses prescription which reveals the ability of the eye to focus light and project a clear image on the retina. Nearsightedness, astigmatism and high farsightedness make the vision  blurry. Children should have the refraction done after dilation which relaxes the the eye. Before dilation the lens, which is very flexible in children, can flex to focus light and give a false refraction. This can result in a glasses prescription that can cause eye strain and headaches.

What are some signs of a vision problem that parents should look out for?
Most children show no signs of vision problems which is why screening is very important. Some signs of eye problems include eye drifting or crossing, squinting, and tilting or turning the face to look at things.

Virginia Eye Institute has 10 offices throughout Central Virginia and services areas including Richmond, Hanover, Henrico, Chesterfield, Colonial Heights, Prince George, Petersburg, and New Kent.
VEI provides treatment for an entire range of ophthalmic needs, including cataract surgery, retinal disorders, glaucoma care, corneal disorders, pediatric eye care and adult strabismus, reconstructive and cosmetic surgery, LASIK and refractive surgery, neuro-ophthalmology, optometry, as well as optical shops for glasses or customized contact lenses

Get 30% discount off eyeglasses, sunglasses & accessories and 10% off contact lenses at VEI with the Savvy Saver app (or just print off the page and bring it in!)


Inna MarcusDr. Inna Marcus, M.D. specializes in pediatric ophthalmology and adult strabismus, including amblyopia, ocular motility disorders, pediatric cataracts and glaucoma.  She received her Doctorate of Medicine from New York University following her undergraduate studies at Columbia University.  Dr. Marcus completed her ophthalmology residency at Yale University, and she completed her fellowship in pediatric ophthalmology and adult strabismus at Duke University. She is a member of the American Medical Association, the American Academy of Ophtalmology, and the American Association for Pediatric Ophtalmology and Strabismus.


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