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Eye and Vision Screening Procedures, Part 5

Department of Blind and Vision ImpairedCreated by Carmen Valdes & Lisa Shearman

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Eye and Vision Screening Procedures

Learning Objectives for Part 5:

1. Methods for testing vision for infants and toddlers.

a. Testing eyes for near fixation.

b. Testing eyes for far fixation.

c. Testing for tracking.

d. Testing for eye preference.

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Fixation on ObjectThe Near Fixation (at 8-18 inches) tests the child’s eyes while focusing on an object or light. The examiner notes whether the child alternates, prefers fixation with one eye, or can hold fixation well with either eye. 

Type of object to use: 4x5 inch object at 2 months old 1 inch object at 4 months old Cereal at 6 months old

The Distance Fixation (at 10 feet) tests the child’s eyes while focusing on an object or light.

Type of object to use: 4 inch object at 9 months old

Recommendations:Pass: Steady fixation Refer: Fleeting or not able to fixate

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Tracking (horizontal, vertical)Tracking is used to test visual efficiency using eye teaming (identification of any eye turns) and eye tracking (large eye tracking ability).

3 months 50 degrees either side of midline horizontally at 12 inches in front of the child’s eyes30 degrees above and below midline vertically

6 monthsFull 180 degree arc with smooth transition over midline

10 monthsFull 180 degree arc without moving the head

Recommendations:Pass: Smooth Tracking Refer: Jerky or not present

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Eye PreferenceTesting for eye preference can consist of refusal of the child to have the right eye covered while not objecting to having the left eye covered is interpreted as evidence for reduced visual acuity in the left eye. An example of preference is when the child consistently turns head to use one eye to look at objects.

There should be no eye preference

Recommendations:Pass: No eye preference Refer: Demonstrate a preference

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Shifts Gaze

By 4 months, the baby should be able to shift gaze between objects

At 4 months Able to shift gaze between two

objectsAt 6 months

Smoothly shift gaze across midline

Recommendations:Pass: YesRefer: No

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References

First Look, Vision Evaluation and Assessment for Infants, Toddlers, and Preschoolers, Birth Through Five years of Age , (1998) California Department of Education, Sacramento, California,

http://www.cde.ca.gov/spbranch/sed/look.htm

Appleby K., M.A., (2002) Vision Assessment of Infants and Children with and without Special Needs, Parts1 & 2, Vision Associates, Lake City, Florida

http://www.visionkits.com/images/1026/1026.html

Smith Millie, and Levack Nancy, (1996) Teaching Students with Visual and Multiple Impairments, A Resource Guide, Second Edition, Texas School for the Blind and Visually Impaired, Austin, Texas

http://www.tsbvi.edu/publications/vmi.htm

Essential Elements in Early Intervention, Visual Impairments and Multiple Disabilities , (1999) Chen, Deborah, Ph.D., editor, American Foundation for the Blind, New York, N.Y.

www.Afb.org

Anthony Tanni, Story Andrea, and Patterson James Dr., Vision Screening for Young Children Early Intervention Programs, Developed by the Vision Impairment Services for Infants and Toddlers Program, Anchorage, Alaska )

http://www.tsbvi.edu/Education/Vision%20Screening%20Form%202001.rtf

Bishop Virginia E. Ph.D., (1998), Infants and Toddlers with Visual Impairments, http://www.tsbvi.edu/Education/infant/

LH MATERIALS , Assessment of Vision in Children By (2001) Lea Hyvärinen, MDhttp://www.lea-test.sgic.fi/

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Thank You!

This completes the training for Visual Screening.