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Alaska Blind Child Discovery

A cooperative, charitable research project to vision screen every preschool Alaskan

AAP Vision Screen Guidelines

ABCD History

The American Academy of Pediatrics (AAP) combined with AAO and AAPOS recommend the following Age-Appropriate Pediatric Vision Screening Guidelines, consistent with recommended Immunization Schedule:

Any Child with Systemic Risk Factors or "Warning Signs of Pediatric Eye Disease" should have A Confirmatory Eye Examination.

Newborns: The pediatrician should observe the appearance of the eyelids and external eyes, then carefully view the "Red Reflex" with a direct ophthalmoscope to rule out Congenital Cataract.

Infants: Pediatricians should add to regular observation of the face, eyelids and eyes and directed observation to whether both eyes, and each eye independently, can equally follow an interesting object (Cover Test and Fixation). The direct ophthalmoscope can be used to check the Enhanced Brückner Test.

Toddlers: Photoscreening and/or remote autorefraction can determine if your child is focused and aligned on an interesting object.

Pre-school: Children aged 4 and older should be able to describe or match a distance acuity test. The pediatrician MUST ASSURE that each eye is tested independently; this is best done by PATCHING THE UNTESTED EYE.( Photoscreening and remote autorefraction remain valid vision screening measures in preschool)

School Age: Pediatricians and School Nurses continue to test children for unilateral acuity and can add tests of binocularity (stereopsis) and color vision.

1.Donahue SP, Baker CN, Committee on P, Ambulatory Medicine AAoP, Section on Ophthalmology AAoP, American Association of Certified O, American Association for Pediatric O, Strabismus, American Academy of O: Procedures for the Evaluation of the Visual System by Pediatricians. Pediatrics 2016, 137(1):1-9.
2. Donahue SP, Baker CN: Visual System Assessment in Infants, Children, and Young Adults by Pediatricians. Pediatrics 2016, 137(1):28-30.
3. VIPS. Comparison of preschool vision screening tests as administered by licensed eye care professionals in the vision in preschoolers study. Ophthalmology. Apr 2004;111(4):637-650.

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ABCD Guidelines:

Vision Screening
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Introduction to Validation Video
2016 AAP  
Educational CD from Dr. Robert Hered at Nemour's Children's Hospital


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