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The Screening Sequence According to the Protocol
Pupillary Response Light Near
Blink Response Hand Near
Convergence Light or toy Near
Muscle Balance Light; hand Near
Fixation Object: 4" x 5" Near (8" to 18")
Fixation Object: 1" Near (8" to 18")
Fixation Object: Cheerio Near (8" to 18")
Fixation Object: 4" Distance (10')
Tracking Light or toy Near
Eye preference (observational) (any distance)
Shift Gaze Two objects Near
Visual Fields Toy; light Near

The screening sequence according to similar tasks and/or distances:

Fixation at 10'

  • Fixation at 8" to 18"
  • Tracking and Convergence
  • Shifting Gaze
  • Pupillary Response
  • Muscle Balance

*Fields Blink Response

*Note: Fields testing is difficult enough for adults, let alone children; it is extremely difficult (and not very reliable) with very young children (even ophthalmologists don't normally do it with young children).

My personal feeling is that the examiner will uncover enough information in the intake interview to warrant referral; if this is not the case, observation during screening will pick up additional clues if there is a visual impairment. Precise results on the screening tasks will only add more information, and documents that information.

Summary of ECI Policy:

  1. Attention to the possibility of a visual impairment must occur at the intake process.
    1. If there is an eye report among the medical records, no other vision screening is necessary; refer to the VI teacher.
    2. if there is no eye report among the medical records, complete the intake questionnaire about vision; do a vision screening
  2. Reports must be shared between ECI and VI personnel
  3. A VI teacher must be on the IFSP team when there is a visual impairment. Timing is important; share reports, and make referrals Immediately when a vision problem has been identified.

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