By: Daniel A. Greninger, MD, FAAO, FAAP
A vision screening is a brief eye and vision check to help detect vision issues in children. It is an essential part of preventative eye care. Some eye problems in children first show up with squinting, blinking, red eye or other noticeable symptoms. However, other eye problems can have no symptoms and will only be detected during screening.
Some eye problems can cause permanent vision loss if left untreated in childhood. That's why it is important for your child's pediatrician to physically examine the eyes at each
well-check visit, and start formal vision screening tests once they're old enough.
What happens in a vision screening?
Vision screenings may be performed in different ways depending on your child's age. Some screenings need your child's cooperation to read or match images in an age-appropriate way. Other screenings use special tools to measure the eye position, reflection of light off the back of the eye or focus of light into the eye.
What happens if my child fails a vision screening?
If your child fails a vision screening they usually are referred to an eye doctor. This should be an ophthalmologist or optometrist who is experienced in the evaluation and treatment of children.
It is important to follow up with the eye doctor even if you are not noticing any vision problems. The eye doctor should perform a full eye examination. This includes dilating the pupils with eyedrops, and then telling you if your child needs eyeglasses or some other treatment.
When should my child's eyes get screened?
The American Academy of Ophthalmology and the American Academy of Pediatrics recommend that children have their eyes checked starting as newborns. After that, screenings are recommended during
well-child visits.
Vision screening schedule for infants and children
- Newborns: At birth babies should have their eyes checked by their pediatrician for birth abnormalities, infections, cataracts and
glaucoma.
Premature babies may need further specialized exams by an eye doctor when they're born.
- Birth to 6 months: This is a time to talk with your pediatrician about any family history of childhood vision problems. The doctor will check the red reflex (light reflected through the pupil from the back of the eye), using a handheld device called an ophthalmoscope. They'll also have a look at the size and shape of the pupil and external parts of the eye.
- 6 months and up: Your pediatrician will continue to check the red reflex, pupils, and external eye structures. In addition, they will check if each of your child's eyes will look at and appropriately follow a toy or face. They will also look for signs of
strabismus (eye misalignment or "wandering eye.")
- Starting at 1 to 2 years: At this age, instrument-based screening devices may begin to be used for vision screening. These may include photoscreeners and autorefractors, computer-automated devices that use light and cameras to gauge how well your child can see.
- Starting at 3 years: Visual acuity screening is recommended at ages 4 and 5 years, as well as in cooperative 3-year-olds. This involves asking your child how well they can see the details of letters or symbols from a set distance.
More information
About Dr. Greninger
 Daniel Greninger, MD, FAAO, FAAP a member of the AAP Section on Ophthalmology, is a Pediatric Ophthalmologist with Kaiser Permanente in Antioch, CA. He also serves on the Vision Screening Committee of the American Association for Pediatric Ophthalmology and Strabismus.
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