Inspection | Simple observation is useful and should lead the clinician to potential problems. Check the lids and the eyeballs. Check for asymmetry. Can the child (older than 3 months) focus on an object? Check for symmetrical eye movements. |
|
Corneal light reflex/Hirschberg light reflex | This is performed by shining a light (using a penlight) in the child’s eyes and observing where it reflects off the corneas in both eyes. In a child with normal ocular alignment the light reflex lies slightly medial from the center of the cornea. Look for asymmetrical findings comparing the 2 eyes. A possible squint can be detected/suspected. Can be performed from the age of 4 months. |
|
Red reflex | View each red reflex, in a darkened room, individually 30-45 cm from patient’s eyes, and then perform both reflexes simultaneously at a distance of 0.6-0.9 m. A symmetric orange-red light should reflect from each fundus. Any abnormal finding, like an asymmetry of color or occurrence of dark and white spots or lack of red reflex, is a reason for referral to an ophthalmologist. |