Children's vision screening

Before your child starts school, they'll be offered an eye test as part of the See4School programme.

The test, known as pre-school orthoptic vision screening, checks for reduced vision in one or both eyes. It can also reveal other eye conditions.

If left undiagnosed or untreated, eye conditions can cause problems with the way your child’s eyes work together.

Early detection means treatment can be started quickly to help your child begin school with the best vision possible.

Even if your child passes the pre-school orthoptic vision screening, they should still have their eyes examined by a local community optometrist (optician) once a year. This will check the health of their eyes and look for signs of other health problems.

Children under 16 are entitled to a free NHS funded eye examination every year and are also eligible for an NHS optical voucher helps towards the cost of glasses or contact lenses.

Why is the pre-school orthoptic vision test important?

It's very important for children to have their eyes tested. Your child's vision develops rapidly after birth, and anything that interrupts this development can lead to visual impairment in later life, particularly if the child was to lose sight in one eye due to trauma or other eye conditions.

Children rarely complain of having poor vision in one or both eyes, because they don’t know any different. Problems can easily go unnoticed, especially when it only affects one eye.

The pre-school screening programme is vital for detecting amblyopia (lazy eye) and other visual problems as early as possible.

If the test does reveal sight problems, early treatment will lead to better results for your child. By having the test, you can be confident your child will start school with the best possible vision.

Pre-school orthoptic vision screening (See4School) is the only test your child will have before they enter primary 1.

About the test

The test is usually carried out by an orthoptist specially trained in testing children’s eyes. In some health board areas, health care assistants have been trained by orthoptists to carry out the vision test. However, all other tests are carried out by an orthoptist.

All staff involved in testing children are part of the Protecting Vulnerable Groups (PVG) membership scheme managed and delivered by Disclosure Scotland.

Screening invitation

Vision screening is offered to children registered with a GP in all NHS Scotland health boards. Roughly 60,000 children a year are tested through See4School.

Depending on your health board's policy, your child will be tested at one of the following 3 locations:

your child’s nursery/school
a community clinic
a hospital eye clinic

In most health board areas orthoptists carry out visits to local nurseries/schools, both privately-owned and council.

If you live in Shetland

If you live in Shetland, you'll be given a pink form by your health visitor during your child's pre-school developmental screening. You should then make an appointment with one of three local community optometrists (opticians) listed on the form. These trained optometrists will perform the test for free.

An opt-out consent policy operates. If you do not want your child to be tested, you must inform the health board, or your child's nursery/school if they're being tested there. If you don't opt out, your child may still be tested.

Opting out of screening

If you don't want your child's vision to be tested, you will need to opt out of screening.

If your child is to be seen at nursery/school you will receive a vision screening questionnaire (PDF, 9.7kb) from your nursery/school or a similar letter of invitation designed by your health board. You must complete this questionnaire if you do not want the test carried out.

If your child is getting tested at a clinic, the appointment letter will have a phone number for you to opt-out and cancel the appointment.

If your child misses their screening

If your child is absent on the day of screening, you'll be offered an appointment for your nearest community or hospital eye clinic.

If you do not receive a rescheduled appointment, contact your health visitor or school nurse. Alternatively, any community optometry practice (opticians) will be able to provide an NHS-funded eye examination.

Find your local optometry practice (opticians)

Taking the test

The test is non-invasive, takes less than 10 minutes and is a fun experience for most children.

The orthoptist will assess your child’s vision using a letter matching or picture naming game, and by getting them to answer simple questions.

They may look at small pictures, follow a light, or look at a 3D picture.

These tests are child friendly and your child does not need to know their letters.

If your child is very shy do not worry. They do not have to speak for the orthoptist to carry out the tests.

The orthoptist will carry out tests specifically designed to detect:

squints
muscle imbalance
binocular vision problems
reduced vision

For the vision test one eye is covered with a patch or a pair of glasses with one eye blanked out. This is very important to make sure unequal vision (amblyopia) is detected.

What isn't tested

Colour vision problems

Colour vision problems are not tested during pre-school screening as they cannot be treated.

If you have a family history of colour vision problems it's recommended to take your child to a community optometrist (optician) to have this assessed when they are in primary 1 or primary 2.

Find your local community optometrist (optician)

Myopic (short sighted) vision problems

The pre-school vision screening test may not detect if a child will become short sighted (myopic) as they get older. That's why it’s really important that children have their eyes examined annually by a community optometrist (optician). You should also schedule an examination if your child complains about objects in the distance being blurry.

Find your local community optometrist (optician)

The test results

If your child is tested at nursery/school the orthoptist will complete an eye test result slip and place it in an envelope with your child’s name. This can be filed in your child’s Red Book.

If you attend a clinic you'll be given this result slip to file in your child’s Red Book.

The results will give one of the following outcomes:

Pass

Your child’s eyes are normal for their age.

If any eye problems are noticed in the future it's recommended that you take your child to a community optometrist (optician)

Find your local community optometrist (optician)

Referred for further assessment

Should your child not pass the eye test, they'll need further assessment. They'll be referred to your nearest community clinic or hospital eye clinic. You may also be asked to take them to a community optometrist (optician).

Find your local community optometrist (optician)

The optometrist or ophthalmologist will carry out an assessment for glasses (refraction) and check the health of your child's eyes.

The results will clearly show any recommended action to help your child's vision.

Test incomplete

This means your child will need to be re-checked by having the test repeated at a later date.

There can be many reasons for this, like your child losing concentration on the day and not being able to complete the test.

Your child will either be re-assessed at nursery/school, or you will be asked to attend a local community clinic or hospital eye clinic to have the test repeated.