My child has a failed vision screening: What next? Could the machine be wrong?

Pediatric Automated Vision Screening:

Vision screening is a cost-effective and efficient way to identify if your daughter or son may have a visual impairment or eye condition that could lead to vision loss. An automated vision screener is used in the office of your pediatrician or at your child’s school, through the regional Lion’s Club International of Connecticut. Here is a slide showing common machines.

The automated photoscreener has a special camera which uses the red reflex which helps identify risk factors for decreased vision. The automated photoscreener is especially helpful in children ages 1 to 4 years old. The red reflex should be equal and the same in both eyes.

What if the red reflex test is abnormal or if there is a ‘failed vision screening’ test?

This happens when an abnormal red reflex triggers the photoscreener’s ‘risk factor’ settings in one or both of your child’s eyes. These risk factors can tell us if your child could be at risk for decreased vision in the future. Decreased vision during childhood is called amblyopia.

So, the photoscreener machine is pre-programed to help us assess if your child could possibly be at risk to have a vision problem.

Why is it is helpful to use a photoscreener so youngespecially before 12 months old?  It is important to screen at 12 months old or younger because we can tell if there could be a vision problem months and years before your child could let us know by identifying shapes, pictures, or letters during an office visit. So, this early intervention is really helpful to help children have the best possible vision develop in both of their eyes!

There are five major risk factor settings on most automated photoscreeners:  nearsightedness (myopia), farsightedness (hyperopia), astigmatism (curved shape of cornea and/or lens), unequal pupil size (anisocoria) and strabismus (eye misalignment).

Does every child who has a ‘failed vision screening’ need glasses?  The short answer is no. Sometimes the automated machine over calls myopia and astigmatism in children.  However—it is important to have a referral to an eye doctor who is comfortable evaluating children for a complete exam. Sometimes, the eye doctor will hold off on giving glasses right away, but still observe and watch your child’s vision closely—maybe needing glasses later in childhood. Other times, the eye doctor will need to give glasses to your child at a young age to help prevent vision loss in one or both eyes—and to help improve vision as soon as possible.

Blog post by Dr. Jennifer Galvin a board-certified ophthalmologist and fellowship trained in pediatric ophthalmology and strabismus. For more information on pediatric eye exams, strabismus, pediatric eye surgery or glasses feel free to contact us at (203) 878-1236. Dr. Galvin is seeing patients in all 5 offices in Westport, Shelton, Milford, Branford, and Orange. We are looking forward to hearing from you soon. Slide from AAPOS (

Accessibility Toolbar

Scroll to Top