Children’s Eye Health & Safety Month: About objective, device-based vision Screening – by Evan Silverstein, MD

Usually, most children do not need a complete eye examination; however, all children should have serial screenings. Objective, device-based vision screening or photoscreening is an excellent way to accomplish screening in young children. With the right referral criteria in place, screenings in preschoolers can help to identify risk factors for amblyopia. Therefore, children’s screening should be performed yearly.

Recently the American Association for Pediatric Ophthalmology and Strabismus added the option of photoscreening for children ages 12 months to 36 months to its recommendations. If a child fails the screening, it is then referred to an eye care provider for a complete eye examination with dilation.1 Not all children who have a refractive error will need to wear glasses; the treatment will depend on their individual situation and factors such as age and the level of risk for developing amblyopia.

Therefore, it is crucial that there is a follow through when a child  is referred with a “Refer” screening result for a complete exam. Communication is key throughout this process, starting with the person who performs the vision screening.

Plusoptix Blog: About objective, device-based vision screening; Evan Silverstein, MD
Evan Silverstein, MD

The screener needs to ensure that parents understand why the child is being referred for a dilated eye exam. Then the eye doctor must clearly discuss with parents what the treatment will be, how it works and again, why this course of action was chosen for the child. Therefore, parents should be educated about the therapy; because when the child is having difficulty, they need to let the physician know so the child can stay on track with treatment.

Objective, instrument-based Vision Screening with the Plusoptix Vision Screener
Objective, instrument-based Vision Screening with the Plusoptix Vision Screener

Working together with parents, teachers, nurses, volunteers, and eye care providers can ensure children receive necessary vision screening and follow-up care. Good vision is vital to learning, and the earlier problems are identified, the sooner they can be addressed. It has been said that 80% of learning and perception is experienced through vision. It is not possible to know this number for certain, but lower test scores and poorer reading and vocabulary are associated with uncorrected visual errors.2-4

As a community, we need to stay vigilant about eye safety and health as well as vision. Parents should limit kids’ access to toys that are essentially projectiles, like Nerf, BB, and Airsoft guns, or sling shots. If children do play with these objects, they must wear eye protection.

Dr. Silverstein is a pediatric ophthalmologist, assistant professor in Virginia Commonwealth University’s Department of Ophthalmology, as well as a member of the Conexus Council for Pediatric Vision and a member of their board. The group’s stated mission is to eliminate undetected  as well as untreated vision problems as barriers to success; enabling all children to reach their fullest potential. The Council for Pediatric Vision reviews and recommends protocols and policies relating to Conexus’ public health and community program activities, to guide the continued delivery of best practice comprehensive children’s vision programs.


Click here to find more Information about the  Plusoptix Vision Screener. 

For further Information concerning references and studies, please refer to our homepage.



  1. American Association for Pediatric Ophthalmology and Strabismus. Vision screening guidelines. Accessed June 14, 2018.
  2. Rosner J. The relationship between moderate hyperopia and academic achievement: How much plus is enough? J Am Optom Assoc. 1997;68:648-650.
  3. Shankar S, Evans MA, Bobier WR. Hyperopia and emergent literacy of young children: Pilot study. Optom Vis Sci. 2007;84:1031-1038.
  4. Williams SM, Sanderson GF, Share DL, Silva PA. Refractive error, IQ and reading ability: A longitudinal study from age seven to 11. Dev Med Child Neurol. 1988;30:735-742. so


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