Pediatric Vision Screening

Noelle S. Matta, CO, CRC, COT; David I. Silbert, MD, FAAP


Int Ophthalmol Clin. 2014;54(3):41-53. 

In This Article

Barriers to Comprehensive Eye Examinations

There are a number of barriers to comprehensive eye examinations.[21–23] Parental understanding, insurance issues involving routine versus medical examinations, transportation, and scarcity of pediatric ophthalmologists for confirmatory examinations. Parents and health care providers often do not realize the importance of vision screening. There is a prevalent attitude that if a child can function adequately, they must be seeing well; however, children can function adequately in early grades of school with very poor vision or with good vision in 1 eye alone. After testing failure, the primary care provider, the school, or the testing site must determine whether and where to refer a child or whether to rescreen. Often a referral is made but not followed through with. A referral to an eye-care provider with little experience with amblyopia or young children may lead to a missed diagnosis of amblyopia. It is critical that children who fail a vision screening have a cycloplegic refraction[24] to determine their refractive state, as noncycloplegic refractions in children can lead to significant errors in refraction.[25]