Ask someone to imagine going to the optometrist and an image will immediately pop into their head: an eye test involving reading letters off a screen. Given this parents often worry about their children’s eye examinations if their children are not yet able to reliably recognise letters. They may even think it’s best to wait until their child has learnt their letters before having their first eye test. Considering how critical vision is in developing literacy and motor skills it’s important to recognise eye problems early, so an eye test doesn’t need to wait.How will I know if my child has an eye problem?It can be difficult to tell if your child has an eye problem. They often lack the language skills to communicate this to their parents as well as having no concept of what “normal” vision is, despite about 1 in 10 preschoolers having problems with their vision. If your child has a problem with their visual acuity (how sharp their vision is, which may be poor if they are long or short sighted) then you may notice them doing things such as squinting, holding objects very close or far from their eyes, avoiding activities that require good eyesight such as colouring, rubbing their eyes frequently or seeming overly clumsy. If you notice any of these warning signs or notice any changes in your child’s eyes then it’s important to book an eye test.Is it possible to check visual acuity?Yes! Optometrists are able to reliably carry out children’s eye examinations in children who can’t recognise any letters. Rest assured, they won’t be asking three-year-old Olivia which Q is clearer or if they preferred the view from lens A or lens B. Optometrists have multiple ways of checking visual acuity in small children. These include:Different eye charts with animals. Instead of asking which letters your child can read the optometrist will ask which animals they can see.Visual charts designed for children who cannot speak. These use cards with stripes of different sizes which will appear clearly at different visual acuities. Children with normal visual acuity will be more attracted to certain cards than others.Retinoscopy. This involves shining a light into the eye and carefully seeing how it is reflected back. As the lens will be different in someone who has normal visual acuity versus someone who is short or long sighted, it is possible to use retinoscopy to check a child’s sight even if they can’t read or talk.What else do children’s eye examinations involve?There’s more to an eye test than just checking visual acuity, and children are no different in this regard. Your optometrist will take a history from you about any conditions your child or close family members may have which can affect eyesight. They will ask about any problems you may have noticed with your child’s vision, such as the signs of poor visual acuity mentioned above or other problems including red weepy eyes or pupils turning in or out. After this they will carefully examine both the outside and inside of your child’s eye, looking for any visual changes that might require treatment or further investigation. Your child’s eye health is critical for good health and good vision, so this is a very important part of children’s eye examinations.What happens after the examination?Depending on the results your optometrist may advise your child needs glasses, refer you to see an eye doctor or recommend further checkups as your child grows. Make sure that you understand when your child will next need a checkup and that any concerns you had have been addressed.