Children up until even 8 or 9 find an eye test that is made for them much easier to do, which makes it more accurate.
The downloadable PDFs on this page include 1 test sheet for each eye, according to the child’s age. Simply print out the page and it is already calibrated for testing at 1.5m from the child. An instruction page is included that also has the matching symbols and letters used in the test so that the child can hold this and point if they prefer to be non-verbal. Nurses and technical staff (or parents at home) doing the test use this page to decide whether or not the child will be able to perform a test reliably.
The room where testing is done should have normal lighting (not dark/dim). Do not stand or sit in front of a window holding the page, ie the child shoud not be looking into the brightness/glare of a background light source.
This is a threshold test – so if the child reads every letter for that eye they have a normal range of vision for their age, if they fail 1 or more letter or shape even though they have shown you they can identify it when up close, that means they need a full eye check. The threshold of the test (the letter size) depends on the child’s age, and the distance you stand with the test. So please use the age for the child being tested, and measure the distance from where the child’s face will be to where you will hold the test.
Spend time going through the explanation and matching page 1st, no eye patch is worn for this. Don’t show them the test page until an eye is covered and you are 1.5m away!
This picture shows how NOT to cover the eye when testing – there is a nice gap between occluder and nose for them to look around.
You should ideally use a proper elastic band eye patch, positioned well across the bridge of the nose to make sure the child cannot look around it for any child 5 or younger. From age 6 an occluder can be used, or the patch. If child or parent uses a hand to cover the palm, not the fingers, cover the eye.
Use the matching sheet 1st, sit next to the child and point to a shape or letter, ask them to tell you what it is. Go through all of the possible options, ie with a young or pre-verbal child make sure they can point to each shape correctly. You could print out 2 of these sheets, so you can point to one and they point to theirs. The single shape or letter at the top of each test page is there to make sure they are listening and know what you mean before starting the threshold line. It is large enough for them to see easily, if they cannot find or name the larger shape or letter there is no need to continue (re-test or visit iScreen). The lines around the test line are there to provide ‘crowding’ – this makes the test more accurate.
Some 5 or 6 year olds are shy or not confident with their letters. If necessary the young child (standardised for age 3 to 4 years) test can be used, as many of these children respond to symbol matching. However the threshold of this test is slightly lower than ideal for the age 5 to 6 child. If there is even 1 symbol missed the child must be referred.
Some young children will not want to do the test (shy etc), they can either be re-tested another time or referred to iScreen to check for any treatable problem. They do not need to be referred to the eye department nor to an optometrist.