Kids' Vision Screening, Lazy Eye and Eye Health by Age

How vision develops

• Newborns see best about 8 to 12 inches (20 to 30 cm) away, roughly the distance to a caregiver's face. Focus, tracking and color vision improve fast over the first months.
• Eyes that drift or cross now and then are common in the first few months. By about 4 months, eyes should usually work together.
• Children rarely complain about poor vision; they assume everyone sees the way they do. That's why screening matters.

Screening by age

• Newborn and every early checkup: a light check for the red reflex and a look at eye movement and alignment.
• About 12 months to 3 years: many practices use instrument-based screening, a quick camera check that needs no reading.
• About 3 to 5 years: an eye chart with pictures or letters, plus instrument screening if a child can't do the chart.
• A failed screen means a referral to a pediatric eye doctor, not necessarily glasses.

Lazy eye and crossed eyes

• Amblyopia (lazy eye) happens when the brain favors one eye. It responds best to treatment in early childhood, often with glasses, patching or eye drops, so early detection matters.
• Strabismus (eyes that turn in, out, up or down) after about 4 months, or that comes and goes when tired, should be checked.

Signs to mention

• A white, gray or missing red reflection in one pupil in flash photos.
• Squinting, tilting the head, covering one eye, sitting very close to screens or books.
• A droopy eyelid that covers part of the pupil, or eyes that wiggle or shake.
• Constant watery eyes or crusting in a baby, often a blocked tear duct that usually clears by 12 months with gentle massage.

Pink eye

• Red, goopy or watery eyes are often viral and clear on their own. Bacterial pink eye may get drops. Itchy, watery eyes in both eyes with sneezing point to allergies.
• Many children with pink eye don't need to miss childcare, though centers set their own rules.
• Wash hands and don't share towels.

Protecting eyes

• Outdoor time is linked to a lower risk of nearsightedness. Aim for active outdoor play most days, and balance close-up screen time.
• Sunglasses that block UV and wide-brim hats in bright sun and on snow.
• Keep laser pointers, BB guns, fireworks and household chemicals away from children.
• Chemical splash: flush the eye with lukewarm running water for 15 to 20 minutes, then call Poison Control (1-800-222-1222).

When to check in

• Bring up any sign on the list at the next checkup, or sooner if it's new.
• Ask about vision screening if your child hasn't had one by age 3 or 4.
• If something has pierced the eye or your child suddenly can't see, cover it loosely without pressing and go to the ER or call 911.