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

Vision Screening Program Models

There are many types of screening program models. Vision screening can be carried out by the pediatrician, by the school nurse, by organizations coming into preschools, or at community events such as health fairs. All children who are referred from a screening should either have a repeat screening or be referred for a comprehensive examination including cycloplegic refraction. Completed examinations can be tracked to improve the sensitivity and specificity of the screening program, and to encourage parents who have not had a follow-up examination yet to do so.

The American Association for Pediatric Ophthalmology and Strabismus have devised standards for comparing pediatric vision screening methods.[26] These guidelines are set against a child's cycloplegic pediatric ophthalmology examination to determine whether the child's vision screening should have prompted a referral to a pediatric ophthalmologist or whether they should have passed the screening. These guidelines suggest that all children should be referred who have manifest strabismus of >8 prism diopters in primary position and a media opacity of >1 mm. They also suggest that all children should be referred based on their cycloplegic refractive error in diopters and age on the following guidelines (Table 1).