Important Notice

The LEHP children’s vision screening program is for screening purposes only.

It is critical that persons undergoing screening and/or their parents or guardians understand that this is NOT a substitute for a comprehensive eye examination.

It aims to identify ‘common vision problems’ and suggest a referral to an Optometrist or Ophthalmologist when required.

Vision screening and the spot vision screening camera is indicated for use by healthcare professionals or under the direction of a healthcare professional to screen or evaluate individuals for potential refractive errors associated with poor vision.

The Need

Part 1

Children’s Eye Screening Program Need and Purpose

The Lions Eye Health Program

Historically LEHP has concentrated on the following vision issues;

  • Diabetic Retinopathy
  • Macular Degeneration
  • Glaucoma

Now we are adding a new dimension, looking at how vision problems affect a child’s performance at school, in sport and everyday life.

The importance of eye testing Children

Along with allergies and asthma, eye disorders are one of the most common long-term health conditions suffered by children.

1 in 5 Australian children have an undetected vision problem or an eye anomaly which may affect their learning.

According to educational experts, as much as 80% of learning comes from the eyes. If a child can’t see clearly it can have a profound effect on their social and educational development.

Most children will accept vision problems and adapt to their poor sight. They rarely complain as they believe everyone sees the world like they do.
Identifying and correcting issues early in life is paramount to a child’s ongoing development. Some common conditions can also become more difficult to treat as the child gets older.

Common Vision Problems in Children

The most common vision problems experienced by school-aged children are those to do with the size and shape of the eyes that then affects the ability to see clearly and sharply. These problems include:

  • Nearsightedness (where things far away become blurred)
  • Farsightedness (difficulty focusing on things close up)
  • Astigmatism (a distortion of vision).

Behaviours that may indicate a vision issue include; an eye not fully open, frequent blinking, sensitivity to light, squinting, constant turning and tilting of the head, holding a book close to read it, rubbing of the eyes, confusing of colours, blurred or double vision, burning or itching eyes or if there is unequal colour or brightness in the child’s eyes.

Once recognised, these conditions are usually very easy to correct. Trying to read the teachers whiteboard or complete a mathematical challenge with any of these conditions uncorrected can make learning very difficult. So much so that children can often disconnect and withdraw from classroom activity. They may also have difficulty playing sport and performing daily tasks.

To ensure the best possible start for our kids, early detection of these conditions is the key.

When to get tested

The Australia age-by-age recommendations for eye testing are as follows:

    • Newborns: An eye examination is essential to detect any abnormality.
    • 6-8 weeks: Infants should be fixing and following their parents’ faces as a guide, and eye movements should be normal. Turned or crossed eyes require immediate examination by your GP, paediatrician, optometrist or ophthalmologist.
    • Preschool-aged children: Eye screening or examination is critical for this age group for the detection of lazy eye or other causes of poor vision. Without testing these conditions are often undetected as there are few outward signs or symptoms.
      Optometry Australia recommends that children should have a full eye examination before starting school and regularly as they progress through primary and secondary school.
    • School-aged children: In particular if a child has ongoing problems with reading, concentrating on near tasks, complains of difficulty seeing the board or watching TV, headaches or sore or tired eyes – an examination by an optometrist is required.

Medicare rebates cover part or the entire fee for regular eye examinations for Australians of all ages.

Screenings performed by LEHP

  1. Visual Acuity – using a Lea 3m – 15 line Symbol Vision Chart
  2. Colour Vision – using a Quick 6 – Basic Colour Screening Book
  3. Depth Perception – using a Stereo Fly Screening Tool
  4. Spot Vision Screener – designed to screen for the following common vision problems:
  • Myopia (nearsightedness)
  • Hyperopia (farsightedness)
  • Astigmatism (blurred vision)
  • Anisometropia (unequal refractive power)
  • Strabismus or Gaze (eye misalignment)
  • Anisocoria (unequal pupil size)
Screening is not a diagnosis but an indication that one of these conditions may be present and if so a complete eye examination by an eye health professional is strongly recommended.

Purpose of the Screening

The vision screening activities are designed to answer these questions:

  • Are the eyes in focus when they are relaxed?
    A child may pass the simple vision chart test but it may take some effort of focussing or squeezing the eye lids to make focus better.
    Far sightedness or near sightedness and astigmatism depend on the size and shape of the eyes.
    Anisometropia tests for the amount of error in each eye. (aniso – unequal metropia – measurement)
  • Are the eyes Straight?
    Misalignment can cause strain to maintain single vision, resulting in double vision. The spot screener is very good at detecting this.
    A child may not want to look at near or distance tasks because of the effort required to look at an object.
    They may read or write very close. The eyes have a focus/converging relationship and the two may coincide at a point very close to the eyes instead of what we regard as a ‘good reading distance’.
    One eye may be closed to avoid any doubling or one turns more to allow suppression of one eye. This may not be noticeable to parents or teachers but may be a very small turn that can only be seen through a full eye exam.
  • Are the pupils of equal size?
    Unequal pupil size (Anisocoria) has no significance or rarely causes problems. However it could have neurological implications behind the eyes.
    A child may have a problem with glare if a pupil remains wide open. Although it may not affect clarity of vision.
    A Spot Screener camera is very good at also detecting this condition.
  • Is colour perception within normal range?
    1 in 10 boys and 1 in 100 girls will have an abnormal colour perception.
    It may have little effect on the eyes but may govern future employment opportunities and tasks such as colour matching.
    A Red loss can be quite dangerous as red lights are very dull and it may also be embarrassing when trying to select a ripe apple.
  • Is ‘stereo’ perception within normal range?
    This helps discern if the eyes are working together and co-ordination for close-up work is up to standard.

Now you understand the need to establish this program and why it exists today.

Self Check Questions:

What is the incidence of significant vision problems in Australian Children ?

Why is it important to test children's eyes ?

Hyperopia is ...

Nearsightedness or Farsightedness and Astigmatism depend on ...

Is the screening a substitute for a comprehensive eye examination by a health care professional ?

What can happen if a child has vision issues ?

When should a child's eyes be first tested ?

What can be detected by using the Lea Vision Chart