All Early Head Start children will receive a vision screening within the first 45 days of the child’s first day in the program.


  1. The EHS Staff has primary responsibility for assuring that the vision screening is completed within the 45 day time period.
  2. The EHS Staff is responsible for documenting the vision screening results in WebCAF under the Screenings section, either by doing the documentation directly, or by delegating that task to their Regional Assistant (RA).
  3. Screening recommendations will vary based on the age of the child:
    1. Infants under 12 months: Refer to InfantSee program
    2. 1-2 year old children: Refer to an InfantSee provider– with the understanding that the funding for that visit will come from child’s OHP coverage. If child does not have OHP coverage, contact Health/Nutrition Consultant (HNC) for appropriate optometric referral and funds to be allocated to cover cost of the examination.
    3. 3 yr old: Attempt screening using standard HS vision screening procedures. If child unable to complete screening tasks, then please refer child to HNC.
  4. EHS children whose parents are unwilling or unable to get child to an optometric provider within 45 days are referred to the HNC for follow-up planning.
    1. ** Vision screening options available for ages 13month-3 yr olds if performed only by EHS RN (if family unwilling or unable to accept referral to InfantSee provider)

Risk Assessment Questionnaire
Observation checklist

Fixation stability: Observe using a lighted finger puppet or playpeek-a-boo with the light.

  1. Pass: Eye fixation should be stable
  2. Fail:Nystagmus or unsteady fixation

Equal Vision: Cover one eye while they look at any interesting,dynamic visual target

  1. Pass: Aversion to occlusion is equal
  2. Fail:Aversion to occlusion is significantly greater when you cover one eye versus the other.

Eye Movement: Can they follow an interesting visual target (no noise) into all positions of gaze (Up, Down, Left, Right)

  1. Pass:Can move both eyes into all positions
  2. Fail:Inability to move eyes into all positions

Stereopic Vision: Lang stereo card may be used for 2 – 3 yr olds only if they can see and point to the Star.

  1. Pass:Can see and point to the Star and Elephant
  2. Fail:Can point to the Star but not the Elephant

Policy Council approved: May 2010
Performance Standards 45 CFR Section 1304.20.