Children's eye checks, lazy eye and short-sightedness in Spain

Key rules

• First stop: Your paediatrician checks your child's vision and refers you to ophthalmology if there is a concern.
• School screening: Do not rely on school screening, because it is not general across Spain.
• Babies and suspected squint: Take them to a paediatric ophthalmologist, not an optician.
• Lazy eye: Consultations, patching and surgery are free in public hospitals, but glasses often are not fully covered.
• Myopia control: The public system generally does not cover it, so expect to pay privately.

Who checks your child's eyes

Your paediatrician is the first point of contact. In the public system, vision checks are part of the Programa de Salud Infantil. The doctor, and often a nurse, checks the eyes and the red reflex at birth and in early check-ups. Around age 3 to 4, and again at about 5 to 6, they test visual acuity and look for a squint (strabismus). Exact timing varies by region.

If the paediatrician suspects a problem, they refer your child to ophthalmology. Ask at each check-up whether the eyes were examined.

Do not wait for a school screening. School-based screening is not general, and only some regions run local programmes.

Going to an optician instead

Opticians-optometrists can measure refraction and visual acuity in children. Many offer children's exams from about age 3, and some see younger children with non-verbal tests. Each centre sets its own minimum age.

Opticians cannot treat eye disease or prescribe medicines. Take a baby, or any child with a suspected lazy eye or squint, to a paediatric ophthalmologist instead.

Lazy eye (amblyopia)

Treatment starts with glasses to correct the sight. Then the better eye is covered with a patch, or given atropine drops to blur it, so the weaker eye works harder. If there is a squint, it may be treated with exercises or surgery.

Public hospital ophthalmology and orthoptics services provide the consultations, patching and surgery free. Glasses are often not fully covered. Waiting times vary by region.

Short-sightedness (myopia)

Myopia control in children uses:

• low-dose atropine drops (0.01% to 0.05%), often made up by a pharmacy
• overnight lenses (orthokeratology)
• multifocal or specially designed soft contact lenses
• myopia-control glasses lenses
• more time outdoors

The public system generally does not cover these treatments. Some regions cover monitoring and standard glasses. Most families pay privately for control treatments. Availability of atropine varies, so ask your ophthalmologist and pharmacy.

Help paying for glasses

Glasses for children are mostly not funded nationally. Some regions run their own aid for children's glasses and contact lenses, with income and age conditions. Asturias, Navarra, the Basque Country, Galicia and Murcia have had such programmes. Amounts and eligibility differ, so ask your regional health service what is on offer now.

The checklist and questions below cover the steps and common queries.

Checklist

• Ask your paediatrician at each Programa de Salud Infantil (child health programme) check-up whether your child's eyes have been checked.

• Ask the paediatrician for a referral to ophthalmology if they suspect a problem.

• Book a private optician-optometrist visit for a refraction and acuity test if you want a check from about age 3.

• Ask your regional health service whether it offers aid for children's glasses or contact lenses, and what income and age conditions apply.

Frequently asked questions

Can an optician test my young child's eyes?

Yes, opticians-optometrists can measure refraction and visual acuity in children, and many offer exams from about 3 years old. Each centre sets its own minimum age, and some use non-verbal tests for younger children. Babies, or any child with suspected strabismus or amblyopia, should see a paediatric ophthalmologist, because opticians cannot treat eye disease or prescribe medicines.

Does the public system pay for myopia-control treatment?

No, the public system generally does not cover myopia control, so families usually pay privately. Treatments include low-dose atropine drops (0.01% to 0.05%, often made up by pharmacies), overnight orthokeratology lenses, special soft contact lenses and myopia-control spectacle lenses. More outdoor time also helps.

Does any region help pay for my child's glasses?

Some regions do, but the national catalogue mostly does not fund children's glasses. Regions such as Asturias, Navarra, the Basque Country, Galicia and Murcia have run aid for glasses and contact lenses, with income and age conditions. Ask your regional health service for the current amounts and rules.