Pre-school vision screening

Before your child starts school, they’ll be offered an eye test as part of the See4School programme. This is known as pre-school orthoptic vision screening.

The test checks for reduced vision in one or both eyes. It can also reveal other eye conditions.

Eye conditions can cause problems with the way your child’s eyes work together if left undiagnosed or untreated.

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

Even if your child passes screening, they should still have their eyes examined by an 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. They’re also eligible for an NHS optical voucher. This helps towards the cost of glasses or contact lenses.

Read more about your right to free eye examinations

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. Anything that interrupts this development can lead to visual impairment in later life.

Children rarely complain of having poor vision in one or both eyes, because they don’t know any different. Problems can go unnoticed, especially when it only affects 1 eye. A problem with 1 eye means your child could struggle if they lose the sight in the other eye.

Pre-school orthoptic vision screening 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 have the best possible vision.

About the test

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

All staff involved in pre-school orthopic vision screening are part of the Protecting Vulnerable Groups (PVG) membership scheme managed and delivered by Disclosure Scotland.

Screening invitation

Pre-school orthoptic 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 the screening programme.

Depending on your health board’s policy, your child will be screened at 1 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. This includes both privately-owned and council nurseries and schools.

If you live in Shetland

Pre-school orthoptic vision screening works differently for those who 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 1 of the community optometrists (opticians) listed. These trained optometrists will perform the pre-school orthoptic vision screening for free.

An opt-out consent policy operates. If you do not want your child to be screened, you must inform the health board. If your child’s being screened at nursery or school, you should inform them. If you don’t opt out, your child may still be tested.

Opting out of screening

If you don’t want your child to be screened, you will need to opt out.

If your child is to be seen at nursery/school you will receive a vision screening questionnaire 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 screened 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 misses screening at nursery or school, 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 screening 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 by:

  • using a letter matching or picture naming game
  • getting them to answer simple questions

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

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

Children with additional support needs will be invited to take part in the screening test. The orthoptist can adapt the test as required by individual needs.

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 amblyopia (unequal vision) is detected.

What isn’t tested

Colour vision problems

Colour vision problems are not tested during screening. This is because they cannot be treated.

If you’ve a family history of colour vision problems, you should take your child to a community optometrist (optician) when they are in primary 1 or 2. They’ll be able to assess your child’s colour vision.

Find your local community optometrist (optician)

Myopic (short sighted) vision problems

Pre-school orthoptic vision screening may not detect if a child will become myopic (short sighted) 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)

If your child is screened at nursery or school, the orthoptist will complete an eye test result slip. This will be placed in an envelope with your child’s name. This result slip 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:


Your child’s eyes are normal for their age.

If any eye problems are noticed in the future, you should take your child to a community optometrist (optician).

Find your local community optometrist (optician)

Referred for further assessment

Should your child not pass pre-school orthoptic vision screening, they’ll need further assessment. This might be a telephone or ‘near me’ virtual appointment.

What’s a near me virtual appointment?

NHS Near Me is a secure video consulting service for clinical and wider support appointments.

They take place in your home using a smartphone, tablet or computer. You and your health care professionals can see and talk to each other via a video link.

Read more information about NHS Near Me

Your appointment could also be at your nearest community clinic or hospital eye clinic. Or, you may 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). They’ll also 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. For example, your child may have lost concentration on the day and not being able to complete the test.

Your child will be re-assessed at:

  • nursery
  • school
  • a local community clinic
  • a hospital eye clinic

Your health board will let you know when and where your child will be re-assessed.

Last updated:
02 February 2024

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