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Vision Screening

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What is vision screening?

A vision screening, also called an eye test, is a brief exam that looks for potential vision problems and eye disorders. Vision screenings are often done by primary care providers as part of a child’s regular checkup. Sometimes screenings are given to children by school nurses.

Vision screening is not used to diagnose vision problems. If a problem is found on a vision screening, your or your child’s provider will refer you to an eye care specialist for diagnosis and treatment. This specialist will do a more thorough eye test. Many vision problems and disorders can be successfully treated with corrective lenses, minor surgery, or other therapies.

Other names: eye test, vision test

What is it used for?

Vision screening is most often used to check for possible vision problems in children. The most common eye disorders in children include:

  • Amblyopia, also known as lazy eye. Children with amblyopia have blurry or reduced vision in one eye.
  • Strabismus, also known as crossed eyes. In this disorder, the eyes don’t line up right and point in different directions.

Both of these disorders can be easily treated when found early.

Vision screening is also used to help find the following vision problems, which affect both children and adults:

  • Nearsightedness (myopia), a condition that makes far away things look blurry
  • Farsightedness (hyperopia), a condition that makes close-up things look blurry
  • Astigmatism, a condition that makes both close-up and far-away things look blurry

Why do I need vision screening?

A routine vision screening is not recommended for most healthy adults. But most adults are encouraged to get eye exams from an eye care specialist on a regular basis. If you have questions about when to get an eye exam, talk to your primary care provider.

Children should be screened on a regular basis. The American Academy of Ophthalmology and the American Academy of Pediatrics (AAP) recommend the following vision screening schedule:

  • Newborns. All new babies should be checked for eye infections or other disorders.
  • 6 months. Eyes and vision should be checked during a regular well-baby visit.
  • 1–4 years. Eyes and vision should be checked during routine visits.
  • 5 years and older. Eyes and vision should be checked every year.

You may need to get your child screened if he or she has symptoms of an eye disorder. For infants three months or older, symptoms include:

  • Not being able to make steady eye contact
  • Eyes that don’t look properly aligned

For older children, symptoms include:

  • Eyes that don’t look properly lined up
  • Squinting
  • Closing or covering one eye
  • Trouble reading and/or doing close-up work
  • Complaints that things are blurry
  • Blinking more than usual
  • Watery eyes
  • Droopy eyelids
  • Redness in one or both eyes
  • Sensitivity to light
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If you are an adult with vision problems or other eye symptoms, you will probably be referred to an eye care specialist for a comprehensive eye test.

What happens during vision screening?

There are several types of visual screening tests. They include:

  • Distance vision test. School-age children and adults are usually tested with a wall chart. The chart has several rows of letters. The letters on the top row are the biggest. The letters on the bottom are the smallest. You or your child will stand or sit 20 feet from the chart. He or she will be asked to cover one eye and read the letters, one row at a time. Each eye is tested separately.
  • Distance vision test for preschoolers. For children too young to read, this test uses a wall chart similar to the one for older children and adults. But instead of rows of different letters, it only has the letter E in different positions. Your child will be asked to point in the same direction as the E. Some of these charts use the letter C or use pictures, instead.
  • Close-up vision test. For this test, you or your child will be given a small card with a written text. The lines of text get smaller as you go farther down the card. You or your child will be asked to hold the card about 14 inches away from the face and read aloud. Both eyes are tested at the same time. This test is often given to adults over 40, as close-up vision tends to get worse as you get older.
  • Colour blindness test. Children are given a card with coloured numbers or symbols hidden in a background of multicoloured dots. If they can read the numbers or symbols, it means they probably are not colour blind.

If your infant is getting a vision screening, your provider will check for:

  • The your baby’s ability to follow an object, such as a toy, with his or her eyes
  • How his or her pupils (black center part of the eye) respond to a bright light
  • To see if your baby blinks when a light is shone in the eye

Will I need to do anything to prepare for vision screening?

If you or your child wears glasses or contact lenses, bring them with you to the screening. Your provider may want to check the prescription.

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Are there any risks to screening?

There is no risk to a vision screening.

What do the results mean?

If your vision screening shows a possible vision problem or eye disorder, you will be referred to an eye care specialist for a more thorough eye test and treatment. Many vision problems and eye disorders are easily treatable, especially if found early.

Is there anything else I need to know about vision screening?

There are different types of eye care specialists. The most common types include:

  • Ophthalmologist: A medical doctor who specializes in eye health and in treating and preventing eye disease. Ophthalmologists provide complete eye exams, prescribe corrective lenses, diagnose and treat eye diseases, and perform eye surgery.
  • Optometrist: A trained health professional who specializes in vision problems and disorders of the eye. Optometrists provide many of the same services as ophthalmologists, including performing eye exams, prescribing corrective lenses, and treating some eye disorders. For more complex eye disorders or surgery, you will need to see an ophthalmologist.
  • Optician: A trained professional who fills prescriptions for corrective lenses. Opticians prepare, assemble and fit eyeglasses. Many opticians also provide contact lenses.

References

  1. American Academy of Ophthalmology [Internet]. San Francisco: American Academy of Ophthalmology; c2018. Vision Screening: Program Models; 2015 Nov 10 [cited 2018 Oct 5]; [about 3 screens]. Available from: https://www.aao.org/disease-review/vision-screening-program-models
  2. American Academy of Ophthalmology [Internet]. San Francisco: American Academy of Ophthalmology; c2018. What is an Ophthalmologist?; 2013 Nov 3 [cited 2018 Oct 5]; [about 3 screens]. Available from: https://www.aao.org/eye-health/tips-prevention/what-is-ophthalmologist
  3. American Association for Pediatric Ophthalmology and Strabismus [Internet]. San Francisco: AAPOS; c2018. Amblyopia [updated 2017 Mar; cited 2018 Oct 5]; [about 5 screens]. Available from: https://www.aapos.org/terms/conditions/21
  4. American Association for Pediatric Ophthalmology and Strabismus [Internet]. San Francisco: AAPOS; c2018. Strabismus [updated 2018 Feb 12; cited 2018 Oct 5]; [about 5 screens]. Available from: https://www.aapos.org/terms/conditions/100
  5. American Association for Pediatric Ophthalmology and Strabismus [Internet]. San Francisco: AAPOS; c2018. Vision Screening [updated 2016 Aug; cited 2018 Oct 5]; [about 5 screens]. Available from: https://www.aapos.org/terms/conditions/107
  6. Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health and Human Services; CDC Fact Sheet: Facts About Vision Loss [cited 2018 Oct 5]; [about 4 screens]. Available from: https://www.cdc.gov/ncbddd/actearly/pdf/parents_pdfs/VisionLossFactSheet.pdf
  7. Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health and Human Services; Keep an Eye on Your Vision Health [updated 2018 Jul 26; cited 2018 Oct 5]; [about 3 screens]. Available from: https://www.cdc.gov/features/healthyvision
  8. Healthfinder.gov. [Internet]. Washington D.C.: U.S Department of Health and Human Services; Get Your Eyes Tested [updated 2018 Oct 5; cited 2018 Oct 5]; [about 4 screens]. Available from: https://healthfinder.gov/HealthTopics/Category/doctor-visits/screening-tests/get-your-eyes-tested#the-basics_5
  9. HealthyChildren.org [Internet]. Itaska (IL): American Academy of Pediatrics; c2018. Vision Screenings [updated 2016 July 19; cited 2018 Oct 5]; [about 4 screens]. Available from: https://www.healthychildren.org/English/health-issues/conditions/eyes/Pages/Vision-Screenings.aspx
  10. HealthyChildren.org [Internet]. Itaska (IL): American Academy of Pediatrics; c2018. Warning Signs of Vision Problems in Infants and Children [updated 2016 July 19; cited 2018 Oct 5]; [about 4 screens]. Available from: https://www.healthychildren.org/English/health-issues/conditions/eyes/Pages/Warning-Signs-of-Vison-Problems-in-Children.aspx
  11. JAMA Network [Internet]. American Medical Association; c2018. Screening for Impaired Visual Acuity in Older Adults: US Preventive Services Task Force Recommendation Statement; 2016 Mar 1 [cited 2018 Oct 5]; [about 3 screens]. Available from: https://jamanetwork.com/journals/jama/fullarticle/2497913
  12. Johns Hopkins Medicine [Internet]. Johns Hopkins Medicine; Health Library: Vision, Hearing and Speech Overview [cited 2018 Oct 5]; [about 3 screens]. Available from: https://www.hopkinsmedicine.org/healthlibrary/conditions/adult/pediatrics/vision_hearing_and_speech_overview_85,p09510
  13. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2018. Health Encyclopedia: Types of Visual Screening Tests for Infants and Children [cited 2018 Oct 5]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=90&contentid=P02107
  14. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2018. Health Encyclopedia: Vision Problems [cited 2018 Oct 5]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=90&contentid=P02308
  15. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Health Information: Vision Tests: How It is Done [updated 2017 Dec 3; cited 2018 Oct 5]; [about 5 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/vision-tests/hw235693.html#aa24248
  16. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Health Information: Vision Tests: How To Prepare [updated 2017 Dec 3; cited 2018 Oct 5]; [about 4 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/vision-tests/hw235693.html#aa24246
  17. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Health Information: Vision Tests: Results [updated 2017 Dec 3; cited 2018 Oct 5]; [about 8 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/vision-tests/hw235693.html#aa24286
  18. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Health Information: Vision Tests: Test Overview [updated 2017 Dec 3; cited 2018 Oct 5]; [about 2 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/vision-tests/hw235693.html#hw235696
  19. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Health Information: Vision Tests: Why It is Done [updated 2017 Dec 3; cited 2018 Oct 5]; [about 3 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/vision-tests/hw235693.html#hw235712
  20. Vision Aware [Internet]. American Printing House for the Blind; c2018. The Difference Between a Vision Screening and a Comprehensive Eye Exam [cited 2018 Oct 5]; [about 3 screens]. Available from: http://www.visionaware.org/info/your-eye-condition/eye-health/eye-examination/125
  21. Vision Aware [Internet]. American Printing House for the Blind; c2018. The Different Types of Eye Care Professionals [cited 2018 Oct 5]; [about 3 screens]. Available from: http://www.visionaware.org/info/your-eye-condition/eye-health/types-of-eye-care-professionals-5981/125#Ophthalmology_Ophthalmologists
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