Table 2.

Screening Eye and Vision Examinations

History	Family history of strabismus or other ocular problems like amblyopia. Have the parents seen any misalignments? Does the child focus on an object (after 3 months of age)?
Inspection	Simple observation is useful and should lead the clinician to potential problems. Check the lids and the eyeballs. Check for asymmetry. Can the child (older than 3 months) focus on an object? Check for symmetrical eye movements.
Corneal light reflex/Hirschberg light reflex	This is performed by shining a light (using a penlight) in the child’s eyes and observing where it reflects off the corneas in both eyes. In a child with normal ocular alignment the light reflex lies slightly medial from the center of the cornea. Look for asymmetrical findings comparing the 2 eyes. A possible squint can be detected/suspected. Can be performed from the age of 4 months.
Red reflex	View each red reflex, in a darkened room, individually 30-45 cm from patient’s eyes, and then perform both reflexes simultaneously at a distance of 0.6-0.9 m. A symmetric orange-red light should reflect from each fundus. Any abnormal finding, like an asymmetry of color or occurrence of dark and white spots or lack of red reflex, is a reason for referral to an ophthalmologist.