Paediatric Ophthalmology Vision screening is aimed at detecting eye disorders of children which are amenable to treatment in the early years of life. The recommendations begin with an exam for general eye health in the hospital nursery by a paediatrician or family doctor, followed by a repeat exam at approximately six months of age.
At age 3–4 years, children should again be screened by a paediatrician or a paediatric ophthalmologist, with an emphasis on testing visual acuities, such as by reading an eye chart of pictures or letters. Vision should be rechecked at the age of five with subsequent routine screening vision exams typically done in school.
A Paediatric Ophthalmologist should be consulted if any abnormalities are discovered during these evaluations. An ophthalmologist should also be consulted if a child has any risk factors for eye disease such as a history of prematurity, or a family history of amblyopia, childhood glaucoma, cataracts or eye tumours.
When a child is young, the visual system is maturing. Treatment options which may be very effective during a child’s early years may offer little or no benefit later in life. For this reason, early awareness of eye health certainly can make a major difference.
VISION SCREENING GUIDELINES | ||
AGE | TESTS | REFERRAL CRITERIA |
Newborn to 6 months |
Ocular history Vision assessment
External inspection of the eyes and lids Ocular motility assessment Pupil examination Red reflex examination |
Refer infants who do not track well after 3 months of age
Refer infants with an abnormal red reflex or history of retinoblastoma in a parent or sibling |
6 months to 3 yrs |
Ocular history Vision assessment
External inspection of the eyes and lids Ocular motility assessment Pupil examination Red reflex examination Visual acuity testing Photo-screening Ophthalmoscopy |
Refer infants with strabismus
Refer infants with chronic tearing or discharge Refer children who fail photo- screening |
3 to 5 yrs |
Refer children who cannot read at least 20/40 with either eye. Must be able to identify the majority of the optotypes on the 20/40 line | |
5 yrs and older |
Refer children who cannot read at least 20/32 with either eye. Must be able to identify the majority of the optotypes on the 20/32 line.
Refer children not reading from blackboard |