“But My Child Can See!” — Why Early Eye Checks Still Matter

Why checking your child's eyes early can still be so important

Before having my daughter, I obviously understood the importance of children's eye care from the doctor side of things. But becoming a mom made me think about it differently.

I watch her notice tiny crumbs on the floor that I somehow missed. She recognizes people across the room. She reaches for exactly what she wants. She follows toys, points at things, looks through books, and definitely knows when I'm trying to hide something from her.

So clearly, she can see.

But here's the part I think is easy for us as parents to forget:

“My child can see” doesn't necessarily mean both eyes are seeing equally well or working together the way they should.

And young children usually can't tell us when something isn't quite right.

Babies Don't Know What “Normal” Vision Is

If you suddenly woke up tomorrow and one eye was blurry, you'd immediately know something was wrong. A baby doesn't have that comparison.

Whatever they see is simply how the world has always looked to them.

And if one eye sees clearly while the other doesn't, children can be surprisingly good at functioning with their better eye. They can still recognize Mom and Dad, grab toys, run around, watch TV, and seem completely normal.

They aren't pretending.

They genuinely may not know that one eye isn't seeing as well as the other.

That's one reason amblyopia—or what people often call “lazy eye”—can be easy to miss. Children usually don't complain about the blur because their stronger eye takes over, and the weaker eye can look completely normal from the outside.

And This Is About More Than Needing Glasses

When we examine children's eyes, we're not simply trying to figure out whether they're nearsighted or farsighted.

We're also interested in something much bigger:

How are the eyes and brain learning to work together?

A child's visual system is still developing during the early years of life.

The eyes send information to the brain, and the brain learns how to interpret those images. If one eye consistently sends a much blurrier image—or the two eyes aren't pointing in the same direction—the brain may begin relying more heavily on the better eye.

Eventually, it may start ignoring information from the weaker eye.

That's amblyopia.

The eye itself may be perfectly capable of seeing better, but the brain hasn't learned to use it normally.

And that's why finding these problems while the visual system is still developing can be so important. Amblyopia is generally easier to treat when it's identified at a younger age.

“But My Pediatrician Checked Their Eyes.”

Good! And please keep doing those screenings.

Pediatricians play an incredibly important role in children's eye health.

During well-child visits, they may look at the eyes with a light, check whether the eyes appear straight, watch how your baby follows objects, or use an automated screening device.

You may have seen one of these machines before. Your child looks toward it for a few seconds, it measures light coming back from the eyes, and then you get a PASS or a recommendation for further evaluation.

These devices are especially helpful for babies and toddlers who obviously can't sit down and read an eye chart yet. They can detect things such as significant prescription differences between the eyes and some eye-alignment problems.

But a screening and a complete eye examination aren't exactly the same thing.

A screening is designed to identify children who are more likely to have a problem and need further evaluation. It isn't intended to diagnose every possible eye condition.

Sometimes an Eye Turn Is REALLY Small

When people think of crossed eyes, they usually imagine an eye turn that is fairly obvious. But an eye turn can sometimes be tiny.

There's actually a condition called microstrabismus, which basically means a very small misalignment of the eyes. It can be subtle enough that you might look at your child every single day and never notice anything unusual.

And that's exactly the point.

Not every childhood vision problem announces itself with an obviously crossed eye, a child bumping into furniture, or someone saying, “Mom, I can't see.”

Some problems are subtle.

If there's concern about eye alignment, unequal vision, an abnormal screening, unusual visual behavior, or another more complicated situation, a more detailed examination with an eye-care provider experienced in children—such as a pediatric optometrist or pediatric ophthalmologist—may be appropriate. AAPOS likewise recommends further evaluation when screening raises concerns about vision, alignment, or the appearance of the eyes.

“How Do You Even Check a Baby's Eyes? They Can't Read!”

This is one of my favorite questions.

Your child does not need to know their ABCs—or even be able to talk—to have their eyes evaluated.

Eye doctors have ways of gathering information without asking a baby: “Which is better…one or two?” We can watch how the eyes track and move, look at whether they're working together, examine the structures of the eyes, and use light and lenses to estimate whether there's a significant prescription.

As children get older, testing changes with them. Pictures, shapes, matching games and eventually regular eye charts can be used.

That's why pediatric vision testing looks very different depending on whether the patient is 8 months, 3 years, or 8 years old.

Sometimes Parents Notice Something First

Even with normal screening, I think parents should trust themselves when something just doesn't seem right.

Maybe one eye occasionally drifts in photographs.

Maybe your child consistently closes one eye.

Maybe they tilt their head strangely when looking at something.

Maybe they hold things extremely close.

Maybe they seem unusually sensitive to light, frequently rub their eyes, have an unusual-looking pupil, or simply don't seem to use their two eyes the same way.

It doesn't automatically mean something is wrong.

But it's worth mentioning.

And if a child doesn't pass a vision screening, that follow-up examination shouldn't be put off simply because the child seems to see fine. AAPOS specifically recommends comprehensive evaluation after a failed screening because important problems can otherwise be missed.

Seeing Something Isn't the Same as Seeing Well

I think this is the biggest thing I understand differently now as a parent. We naturally judge our children's vision by what we see them doing.

She saw that.

He recognized me.

She can see the TV.

He picked up that tiny toy.

And those are all reassuring observations.

But they don't tell us whether each eye sees equally well, whether the eyes are properly aligned, or whether the brain is learning to use both eyes together.

A child can compensate remarkably well.

That's why childhood vision screening—and further eye examination when screening, symptoms, family history, or other concerns indicate it—is so valuable. Routine pediatric vision screening is designed to catch most significant problems early, while more detailed examination is appropriate when something doesn't add up.

Now I Look at It Differently

Having my daughter didn't suddenly teach me that children's eye care is important. I already knew that.

What changed was understanding the parent side of it.

When your baby is happily looking around the room, recognizing you, grabbing toys, and exploring everything around them, it's incredibly easy to think:

Of course she can see.

And she can.

But as a parent, what I really want to know is that her vision is developing the way it should—not simply that she can see something in front of her.

Our children depend on us to notice the things they aren't old enough to recognize or explain themselves.

And when it comes to their eyes, earlier detection can sometimes make a lifelong difference.

That's a pretty good reason to keep an eye on those little eyes. ❤️

Sources & Additional Reading

American Association for Pediatric Ophthalmology and Strabismus (AAPOS). AAPOS and Choosing Wisely. Guidance on childhood vision screening and when comprehensive eye examinations are appropriate.

AAPOS — Choosing Wisely Educational Resources

— Suzzane Li, OD, FAAO, ABCMO
Simpli Eye Care PLLC, Managing Optometrist