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Key information to gather and tests to carry out

You should:
  1. find out and record the specific history of conditions which might predispose the child to visual problems, such as family history of refractive error, amblyopia or squint; a difficult birth; abnormal or delayed development
  2. have a range of tests to assess the child’s monocular vision and visual acuity, based on the age and ability of the child
  3. assess ocular muscle balance, using objective and, when feasible, subjective methods
  4. assess stereopsis. Having good stereopsis may indicate the child does not have significant anisometropia, amblyopia or squint
  5. assess near vision
  6. assess refractive error. This is often only possible by objective means in young children. Where necessary use cycloplegic drops to obtain an accurate result
  7. assess accommodation. This is often only possible by objective means in young children
  8. assess the health of their eyes. It may be difficult to obtain a good view of the fundus in young children, but you should attempt to determine normal ocular development. At the very least, you should obtain a clear view of the ocular media, disc and macula
  9. screen colour vision where relevant
  10. if you are not confident in your results, or the examination was problematic, arrange to see the child again after a short interval or consult a colleague with more experience.