Introduction

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, they can cause problems with the way your child’s eyes work together.

Early detection means treatment - glasses, eye patches or both - can be started as soon as possible to help your child begin school with the best vision possible.

Pre-school orthoptic vision screening (https://www.youtube.com/watch?v=vkE3_1ApC0k)

Learn more about pre-school vision testing and watch a child taking the test.

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.

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

Taking the eye test

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

Benefits

Benefits of the 'no-risk' eye test include:

  • detection of sight problems allowing treatment to be started early to give better outcomes
  • your child starting school with the best possible vision
  • all children receive the same standard of test through the See4School programme

An opt-out consent policy operates which may mean some children are tested when the parent does not want them to be.

An early eye test is important

It's very important for children to have their eyes tested.

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.

Pre-school Orthoptic Vision Screening (See4School) is the only test your child will have before they enter P1.

It should be taken because:

  • a child’s vision develops rapidly after birth
  • anything that interrupts this can prevent clear vision

The pre-school screening programme is vital for detecting amblyopia (lazy eye) and other visual problems as early as possible and ensuring a child has the best vision possible for starting school.

Vision problems not picked up and treated in childhood 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.

Screening invitation

Vision screening is offered to all children registered with a GP in all NHS Scotland health boards, apart from NHS Shetland which has its own screening system in place.

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
  • community clinic
  • hospital eye clinic

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

Giving permission

Before the test, you will have the option to opt-out of the screening.

If your child is to be seen at nursery you will receive a vision screening questionnaire (PDF, 9.7kb) from your nursery or a similar letter of invitation designed by your health board.

Only complete the vision screening questionnaire if you do not want the test carried out. NHS Scotland has an opt-out consent policy for vision screening.

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

However:

  • if your child is absent on the day of screening, you'll be offered an appointment, by post, for your nearest community/ hospital eye clinic
  • if your child does not attend nursery then you'll be offered an appointment for your nearest clinic

Taking the test

The eye test is entirely safe and non-invasive. Most children enjoy it.

The orthoptist will assess your child’s vision using a letter matching game or a picture naming game and answering 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.

They will then be asked to match letters or name pictures.

What isn't tested

Colour vision problems are not tested 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 optician (optometrist) to have this assessed when they are in P1 or P2.

This test may not detect if a child will become short sighted (myopic) as they get older.

If there are people in your family who are short-sighted (they may take their glasses off to read or the lenses make their eyes look smaller) it's recommended to take your child to a community optometrist.

This should be done in P6 or P7 or if your child ever says they can't see in the distance.

The test results

If your child is tested at nursery 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 will 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 is recommended that you take your child to an optician (optometrist).

Referred for further assessment

Should your child not pass the eye test and need further assessment:

  • they will either be referred to your nearest community clinic or hospital eye clinic - in some cases you could be asked to take your child to a community optician (optometrist)
  • the optometrist or ophthalmologist will then carry out an assessment for glasses (refraction) and check the health of their eyes
  • the results will clearly show any recommended action following the test

Test incomplete

This means your child will need to be re-checked because they may have been losing concentration on the day and the test needs to be repeated at a later date.

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