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VISION SCREENING
Vision screening is a way to find children who might have eye problems or vision issues. The goal is to find problems early so they can be fixed. Screenings happen at schools, doctor offices, and in the community. If there is a concern about vision, how the eyes line up, or how the eyes look at these screenings, a more in-depth examination with an eye care provider (ophthalmologist) is recommended. Vision screening usually happens many times during childhood.
Eye problems that can be found with vision screening include:
Eye misalignment (eye movement problems, strabismus)
Poor vision development (lazy eye, amblyopia)
Cataract (cloudy spot in the center of the eye)
Unequal pupils (dark spot in the colored part of the eye)
Glaucoma (high eye pressure)
Droopy eyelid(s) (ptosis)
Need for glasses (refractive error)
Vision in children can be tested in different ways depending on the age and ability of the child being screened. The method will change as the child grows.
TYPES OF VISION SCREENING:
CHECKING THE EYES WITH A LIGHT:
At most well child checks, the doctor or nurse will use lights to look at the eyes. The lights can show if the eyes are straight and if the eyes are growing normally. If something unusual is noticed the care provider will recommend more testing with an eye doctor (ophthalmologist).
CHECKING HOW WELL THE CHILD IS LOOKING AT SOMETHING:
Young children and children with slow development do not know how to read an eye chart. But a doctor or nurse who cares for children can still often tell if a child’s vision seems normal for their age. The vision can be tested by covering one eye and then the other and watching how the child reacts. If the child does not seem to have good vision, the care provider will recommend more testing with an eye doctor.
USING AN INSTRUMENT FOR SCREENING:
In this form of screening a machine takes a picture of the eyes and measures if there is a possible need for glasses. It can also find things like eye crossing, abnormal red reflexes (red glow from the back of the eye), and pupil problems (dark spot in the colored part of the eye). The test will give results like PASS, meaning that no problems, or REFER, meaning there may be a problem and further testing by an eye care provider is needed. This screening is generally used from babyhood to early school years.
VISION SCREENING WITH EYE CHARTS:
Eye charts used to check vision in children can have shapes or letters. Charts with shapes are often easier for younger children. The child can name the shape or match them using a handheld card. Children as young as 2 or 3 years old can do this screening.
LEA Chart with matching cards.
A letter chart with the letters H, O, T and V can also be used by young children. Matching can be useful for this chart as well.
HOTV chart
Older children who know their letters can be tested with a letter chart like the ones used for adults.
Sloan eye chart
Checking vision with an eye chart can be hard. It takes time and the child needs to pay attention. Each eye is checked by itself to find the smallest letter or shape it can see. Children who do not see the shapes or letters as well as expected for their age should have more testing by an eye care provider (ophthalmologist). It is very important. The ophthalmologist will do more vision testing and a full eye exam. The ophthalmologist will help treat any problems found on the eye exam. Eye problems in children need to be treated right away to avoid losing vision. This is why it is so important to get a full eye exam when a child has problems on a vision screening.
Updated 04/2024
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