We have all heard the terms’ vision screening’ and ‘eye exam.’ The general public often uses them interchangeably, but did you know that they are not the same? 

Our pediatric eye doctors can examine your child for vision concerns from as young as infancy. Whether it is an eye injury or an eye disease, our physicians are here to answer your questions. Almost always, it begins with a vision screening or an eye exam.

However, there are some significant differences between the two. This article aims to explain the critical differences between a vision screening and an eye exam.


What is vision screening?

According to the American Association for Pediatric Ophthalmology and Strabismus (AAPOS), a vision screening is defined as:

“an efficient and cost-effective method to identify children with visual impairment or eye conditions that are likely to lead to vision loss, so that a referral can be made to an appropriate eye care professional for further evaluation and treatment.”

In other words, it is a relatively short exam to catch potential problems with vision which can then be further investigated by a qualified specialist, such as a ‘pediatric eye doctor,’ officially known as a ‘pediatric ophthalmologist.’

What is an eye exam?

An eye exam is a much more comprehensive examination, which takes longer and may involve several different tests. A pediatric ophthalmologist performs it.

The tests (or in insurance lingo, procedures) conducted include :

Physical examination of the eye

The essential cornerstone of a visit is the complete examination of the outside and the inside of the eye. This checks for the health of all of the parts of the eye. The doctors use tools with lights and lenses to examine the inside of the eye to check the retina’s health, the lens, and the optic nerve.  

On the outside, they explore the eyelids, conjunctiva, cornea, and iris. Many people recognize the piece of equipment called a slit lamp. It has a chin rest patient’s to rest on while the doctor looks through the lens into the eye.


This visual acuity test is the test we usually think of when we remember our eye exams and how doctors checked us to see if we might need glasses. The ‘Snellen chart’ is used, which is a list of letters that get progressively smaller.  

Older patients may be asked to read the letters, starting with the larger letters and moving to the smaller letters. Pediatric eye doctors use other methods to perform refraction for patients who are not verbal or do not know their letters. 

Doctors may give eye drops to relax the focus of the eye. These drops also cause the pupil to dilate (open wider). With the eye’s focusing mechanism, the doctor can measure if there is a need for glasses, even in non-verbal children.

Color blindness test

Difficulty distinguishing between certain red and green shades – red/green color blindness – is common and found in about 8% of males. When your child is old enough to participate in the test, they will have a color vision check as part of their eye exam.

Ocular motility test

The ocular motility test is designed to test for disorders of eye alignment or movement. It is used to determine if there is a condition called strabismus and detect conditions such as convergence insufficiency or weakness.  

Stereoacuity Testing

This is a test of depth perception and useful in determining if the child can use both eyes together (i.e., has standard fusion).


What is the difference between a vision screening and an eye exam?

In short, an eye exam is much more thorough and lasts longer (up to 60 minutes) than a vision screening. An eye exam is conducted by a pediatric eye doctor, aka a pediatric ophthalmologist.

Basically, an eye exam is necessary when a disease or disorder is suspected. Eye drops may be used to dilate the eyes. This allows the ophthalmologists to have a better view of the eyes. 

The eye drops dilate the eyes. With dilation, the pediatric eye doctor can get a better view and any signs of disease easier to determine. 


Reasons to have an eye exam

According to AAPOS and the American Academy of Ophthalmology, parents should schedule an eye exam for their child if:

  • Their child fails a vision screening;

  • The vision screening is inconclusive or cannot be performed;

  • A pediatrician or school nurse indicates an eye exam is required;

  • Their child complains of problems with their vision;

  • Their child has a learning disability, developmental delay, neuropsychological condition, or behavioral issue.

  • The child reaches 3-4 years of age and has not yet had an eye exam.

At What Age Should a Child Have an Eye Screening? 

Children should have their first comprehensive eye exam at six months of age. After that, they should have their eyes examined at the age of 3 and then just before first grade (age 5 or 6). 

School-aged children should have regular eye exams every two years but if they have glasses then it is recommended by ophthalmologists they are seen annually. 

Your child’s eyes can be screened by a pediatrician, family doctor, ophthalmologist, or a properly trained health care provider. 

Screenings are often offered at schools, community clinics, or public health events. 


About our  Pediatric Eye Physicians in NJ 

Dr. Amy Lambert

Dr. Lambert, a board-certified pediatric ophthalmologist and strabismus surgeon, is the Pediatric Eye Associates, LLC founder. Originally from New Jersey, Dr. Lambert attended public schools in Millburn before attending Bryn Mawr College in Pennsylvania, where she graduated magna cum laude. 

After receiving her MD from Case Western Reserve University in Cleveland, Ohio, Dr. Lambert completed an internship at Yale University’s Department of Internal Medicine and a three-year residency in ophthalmology at New York University, where, in her final year, she was selected to be a chief resident of the program. 

Following her residency, Dr. Lambert worked as a fellow in pediatric ophthalmology and strabismus at Indiana University, one of the nation’s top training programs for this subspecialty.


Dr. Rachel Bloom

Rachel Bloom, MD is a board-certified, fellowship-trained pediatric ophthalmologist.

Originally from Long Island, New York, and a summa cum laude graduate of Brandeis University, Dr. Bloom received the prestigious Alumni Scholarship to attend medical school at Albert Einstein College of Medicine in New York. 

She completed her ophthalmology residency and fellowship in pediatric ophthalmology and strabismus at the Albert Einstein College of Medicine, Montefiore Medical Center.


Pediatric Eye Associates – Further Information

Every child is different, but all require the best quality of care, and we are here to provide just that. Don’t hesitate to come to see us – the sooner a vision abnormality is detected, the sooner we can start treating it.  

We are always happy to answer any questions you may have. Contact us if you’d like to schedule an appointment at our office or if you have any questions regarding Pediatric Eye Associates.

We are looking forward to seeing you soon!