Vision Screening Recommendations

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Paediatric Ophthalmology Vision screening is aimed at detecting eye disorders in children who 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 pediatrician 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 pediatrician or a pediatric 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 tumors.
When a child is young, the visual system is maturing. Treatment options that 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 the blackboard

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