Vision Screening Online Training Program - Vision History

Vision Screening Online Training Program

Module 2: Vision History
(C&TC: Often performed by the health care provider)

A thorough assessment of risks indicated by the child and family's vision health history is an important part of the child's checkup because many eye conditions are hereditary.

A referral to an eye care professional may be based on the family and child's history alone.

(Often conducted by the health care provider as part of health history)

Provider interveiwing a mother and two children


Newborn through 5 years, or at any age if family history is unknown. Continue to update ocular history at each subsequent screening or C&TC well child visit.


Identify a child/family history of any medical condition that may be associated with eye disorders.


Elicit information of selected medical conditions and syndromes from the parent/caregiver that may indicate the need for referral even if other screening procedures are passed.

Include a review of the following risk factors for potential vision conditions recognized by the American Academy of Pediatrics and the National Center for Children’s Vision and Eye Health at the National Center for Children's Vision Health:

  • Prematurity <32 weeks
  • Family history of:
    • Congenital cataracts
    • Retinoblastoma
    • Metabolic or genetic diseases
    • Amblyopia
    • Wearing glasses before 6 years of age
    • Significant developmental delay
  • Neurological difficulties such as seizure disorders (refer to Child Vision History Questionnaire)
  • Systemic diseases associated with eye abnormalities.

Additionally, the parent/caregiver is asked to identify any complaints or unusual visual behavior their child may have exhibited.


Child Vision History Questionnaire for Parent/Caregiver

Teacher and Child Vision Prescreening Worksheet


Parent/caregiver is given the forms to complete and answers are reviewed and flagged if there is a significant history of conditions, syndromes, risk factors for vision conditions, or concerning behaviors reported.

If parent/caregiver has questions regarding the form, a contact number for referral/follow-up should be given.


No family history of associated conditions, syndromes or concerning vision behaviors are identified.


Family history or personal history of associated conditions or syndromes or concerns are reported.


Children with a family history of eye conditions only have a small likelihood of developing an eye condition themselves?

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