Patient Resources

Vision Screening Recommendations

Age

Test

Referral Criteria

Newborn to 12 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

12 to 36 months
  • Ocular history
  • Vision assessment
  • External inspection of the eyes and lids
  • Ocular motility assessment
  • Pupil examination
  • Red reflex examination
  • Visual acuity testing
  • Objective screening device “photoscreening”
  • Ophthalmoscopy
  • Refer infants with strabismus
  • Refer infants with chronic tearing or discharge.
  • Refer children who fail photoscreening.

36 months to 5 years
  • Ocular history
  • Vision assessment
  • External inspection of the eyes and lids
  • Ocular motility assessment
  • Pupil examination
  • Red reflex examination
  • Visual acuity testing (preferred) or photoscreening
  • Ophthalmoscopy
Visual acuity thresholds:
  • Ages 36-47 months: Must correctly identify the majority of the optotypes on the 20/50 line to pass.
  • Ages 48-59 months: Must correctly identify the majority of the optotypes on the 20/40 line to pass.
  • Refer children who fail photoscreening.

5 years and older*

  • Ocular history
  • Vision assessment
  • External inspection of the eyes and lids
  • Ocular motility assessment
  • Pupil examination
  • Red reflex examination
  • Visual acuity testing 
  • Ophthalmoscopy
  • 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 at grade level.

*Repeat screening every 1-2 years after age 5