The UK NSC recommendation on Vision defects screening in children

Recommendation Systematic population screening programme recommended
Last review completed August 2019
Next review due in 2022/23
Key downloads

Screening for visual impairment between 4 and 5 years of age should be offered by an orthoptic-led service.


Although refractive error and strabismus would be detected by screening, amblyopia is the most likely condition to be detected in this age defined population.


Find general information about population health screening.

Why is screening recommended by UK NSC?

The UK National Screening Committee recommends that screening of children’s eyes should continue to be offered to all children aged 4 – 5 years.  This service should be organised and led by specialists (orthoptists). The review found that:  

  • Amblyopia, when the eye doesn’t work properly even though it appears normal, is the main problem found by screening in this age group.
  • Treatment by covering the good eye with a patch has been shown to help correct sight in the affected eye.  However, it is possible that the problem with the child's eye can come back again after treatment has stopped.

The Committee would welcome research to understand more about the long term effects of amblyopia and the long term effects of treatment.

More about Vision Defects

Vision defects in children include amblyopia, refractive error and strabismus. Amblyopia, when the eye doesn't work properly, even though it appears normal, is one of the main problems affecting children aged between 4 and 5 years. Other problems affecting the eye include refractive error (short or long sight) and strabismus (squint). Amblyopia can be a very mild problem but can become more serious if left untreated or if sight in the other eye is lost or damaged.

Children's sight is tested using charts with letters in rows of different sizes. They start off large at the top and get smaller as they get closer to the bottom of the chart. Children are asked to read the letters out from a particular distance, until they can read no more.

>>Read more about eye tests for children on NHS UK


British and Irish Orthoptic Society
British Association of Behavioural Optometrists
College of Optometrists
Communication Trust
Faculty of Public Health
Institute of Child Health
Optical Confederation
Royal College of General Practitioners
Royal College of Ophthalmologists
Royal College of Physicians
Royal College of Physicians and Surgeons of Glasgow
Royal College of Physicians of Edinburgh
Royal National Institute of Blind People (RNIB)
UK Vision Strategy
Vision Checks

The stakeholder groups will be involved when the recommendation is next reviewed. If you think your organisation should be added, please contact us. More information for stakeholders can be found in appendix C of the UK NSC evidence review process.

Related documents

icon Evidence summary (2013) (PDF document, 1000KB, 19/12/13)
icon UK NSC cover sheet & consultation responses (2013) (PDF document, 706KB, 18/12/13)

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