Age | Important aspects of history | Examination | Ophthalmology referral indications |
Newborn to 6 months | Birth weight <1500 grams or gestational age <30 weeks Family history of:
| Vision assessment (fixate and follow response) External eye examination (lids, orbit, conjunctiva, cornea, iris) Pupillary response Simultaneous red reflex |
|
6 to 12 months | Neurologic abnormality Systemic disease associated with eye abnormalities Does the infant recognize faces and objects? Does the infant fix and follow? Do the parents notice:
| Vision assessment (fixate and follow response) External eye examination (lids, orbit, conjunctiva, cornea, iris) Ocular motility Pupillary response Simultaneous red reflex |
|
1 to 3 years | Neurologic abnormality Systemic disease associated with eye abnormalities Does the child recognize faces and objects? Does the child fix and follow? Do the parents notice:
| Age-appropriate visual assessment:
Instrument-based vision screening (eg, photoscreening, autorefraction) if available External eye examination (lids, orbit, conjunctiva, cornea, iris) Ocular motility Pupillary response Simultaneous red reflex Ophthalmoscopy if possible |
|
4 to 5 years | Neurologic abnormality Systematic disease associated with eye abnormalities Does the child recognize faces and objects? Do the parents notice:
| External eye examination (lids, orbit, conjunctiva, cornea, iris) Ocular motility Pupillary response Simultaneous red reflex Corneal light reflex Ocular alignment (cover-uncover test) Monocular visual acuityΔ◊:
Instrument-based vision screening (eg, photoscreening, autorefraction) if available Ophthalmoscopy if possible |
|
>6 years | Neurologic abnormality Systematic disease associated with eye abnormalities Does the child recognize faces and objects? Do the parents notice:
| External eye examination (lids, orbit, conjunctiva, cornea, iris) Ocular motility Pupillary response Simultaneous red reflex Monocular visual acuity◊:
Ophthalmoscopy if possible |
|
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