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Vol. 24 - Num. 95

Original Papers

How is vision screening performed in primary care?

María Prieto Arcea, Mireya Orío Hernándezb, Marcello Belluscic, M.ª Elena Cabezas Tapiad, Manuel Praena Crespoe

aPediatra. CS San Agustín. Burgos. España.
bPediatra. CS Alcalde Bartolomé González. Móstoles. Madrid. España.
cPediatra. Unidad de Enfermedades Metabólicas. Hospital Universitario 12 de Octubre. Madrid. España.
dPediatra. CS de Villaviciosa de Odón. Villaviciosa de Odón. Villaviciosa de Odón. Madrid. España.
ePediatra. CS La Candelaria. Sevilla. España.

Correspondence: M Prieto . E-mail:

Reference of this article: Prieto Arce M, Orío Hernández M, Bellusci M, Cabezas Tapia ME, Praena Crespo M. How is vision screening performed in primary care? . Rev Pediatr Aten Primaria. 2022;24:e301-e312.

Published in Internet: 11-10-2022 - Visits: 794


Introduction: amblyopia is the most frequent cause of preventable vision loss in developed countries. Its prevention depends on early detection and treatment through adequate vision screening in childhood. Our objective was to describe the current situation in vision screening at the primary care level in Spain and its association with the training of professionals.

Material and methods: observational descriptive study via a remote survey of primary care paediatricians of their knowledge on visual development and vision screening techniques, equipment and training. We conducted a statistical descriptive and univariate analysis to assess the association between the training received and the level of knowledge. 

Results: of all respondents, 79.3% answered the theoretical questions correction, 82.8% had standardised optotypes and 30.7% used the Lang test. Also, 72.7% knew the adequate distance and 76.6% the optimal height to assess visual acuity with optotypes. Fifty percent used the red reflex test, 68.3% the Hirschberg test and 44.5% the cover test in the appropriate check-ups. As regards training, 3.1% received it from their institutions, and 54.8% independently. Over 90% knew the criteria for referral to the ophthalmologist. We found differences in the scores of the respondents based on the training received.

Conclusion: we identified opportunities for improvement: the red reflex test should be performed during all infant check-ups and ocular alignment checked from 6 months, and the Lang test and standardised optotypes should be available and their use improved. Higher levels of theoretical and practical knowledge are positively correlated with the amount of training received by health professionals.


Amblyopia Strabismus Vision screening Visual acuity


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