Vision Screening

By Admin, March 1, 2013

What is vision screening?

Vision screening is an effective method to identify children with visual impairment or eye conditions that are likely to lead to visual impairment so that a referral can be made to a Paediatric Ophthalmologist/ Child eye specialist for further evaluation and treatment.

How is vision screening performed?

There are a number of methods used to screen a child’s vision.

Inspection of the eye, pupils and red reflex

This method can be used on children of all ages. At each well child visit, the examiner uses a flashlight to inspect the eyes for abnormality of shape or structure and to detect irregularity in pupil shape. An ophthalmoscope is used to observe the red reflex of the eye.


This is an automated technique that uses the red reflex to identify many types of eye problems. An advantage of this screening is that it is quick and thus useful in very young children. The newest generation of photoscreeners provides immediate information about the eye condition.

Corneal light reflex

This simple test can be performed on any child using a penlight. As a child focuses on a penlight, the position of the light reflection from the front surface (cornea) of the eye is observed.

Cover testing

This test detects misalignment of the eyes. While the child focuses on a target, the examiner covers each eye sequentially to look for a “shift” in the alignment of the eyes.

Subjective visual acuity testing

Special vision charts are used to evaluate childs’ vision.

What kinds of eye problems can be detected on a vision screening?

The main goal of vision screening is to identify children who have or are at risk to develop amblyopia, which can lead to permanent visual impairment unless treated in early childhood. Other problems that can be detected by vision screening include squint, cataract, glaucoma, refractive errors, ptosis and other more serious conditions such as tumors or neurological diseases.

Who performs vision screening?

Pediatricians, family physicians, nurses and technicians can perform vision screening at regular visits. In addition, many day care programs, schools and health departments offer vision screening programs for children.

What if a child fails his or her vision screening or cannot cooperate for vision screening?

If a child fails a vision screening at any age, the child should be referred for a comprehensive eye examination.

By age 3 or 4 years, most children are able to cooperate for subjective visual acuity testing using an eye chart. If a child is unable to cooperate for visual acuity testing at age 3, a second attempt should be made within 6 months. If retesting is impossible or inconclusive, then the child should be referred to paediatric ophthalmologist/ child eye specialist.