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