[This table is from: Leffler CT. Visual impairment. In: Accardo PJ (ed). Developmental disabilities in infancy and childhood. Johns Hopkins Univ. Press. Balto., MD 2007. pp 501-520.
It may be far down on the web page, so keep scrolling down. It originally was two columns, but it is only completely displayed on this website if it is reformatted to one column.]

Table 1. Development and assessment of the eye.

Gestational Age.

22 days.

Optic primordia appears.

Any birth.

→Fundus checked for red reflex.
→Corneal light reflex tested.
→Cover test performed.

30 weeks.

→Screening for retinopathy of prematurity by ophthalmologist required for gestational age <= 30 weeks or birthweight < 1500 g.
Pupillary light reflexes may be present.
Lid closure in response to light.

34 weeks.

Vestibular (doll’s head) eye rotations well-developed.

Term Age.

Birth.

Visual fixation present.
Optokinetic nystagmus and conjugate horizontal gaze well-developed.
Visual acuity 20/400.

1 month.

Pupillary light reflex well-developed.

2 months.

Fixation and conjugate vertical gaze well-developed. Color vision present.

2-5 months.

Blink response to visual threat.

3 months.

Visual following well-developed.

4 months.

Accommodation well-developed.
Eyes should be well-aligned in the absence of pathology.

6 months.

Color vision at adult level. Fusional convergence and iris stromal pigmentation
well-developed. Stereopsis developed.

1 year.

Visual acuity 20/50.

2 years.

Acuity by grating preferential looking or Snellen chart at adult level (20/20).
→Check fundus with direct ophthalmoscope.

3 years.

→Check visual acuity. Refer if <4 of 6 correct on 20-feet line with either eye tested at 10 feet (<10/20 or <20/40) (AAP 1996).
Refer if 2-line difference between eyes (i.e. 10/12.5 and 10/20 or 20/25 and 20/40) (AAP 1996).
→Cover test at 10 feet. Refer for any eye movement (AAP 1996).
→Random-dot-E stereo test at 40 cm (630 seconds of arc). Refer if <4 of 6 correct (AAP 1996).

6 years.

→Check visual acuity. Refer if <4 of 6 correct on 15-ft line with either eye tested at 10 ft. (ie, <10/15 or <20/30) (AAP 1996).
Refer if 2-line difference between eyes (ie, 10/10 and 10/15 or 20/20 and 20/30) (AAP 1996).

7 years.

Stereoacuity at adult level.

10 years.

End of critical period for monocular visual deprivation.

→Required tests which may result in ophthalmology referral. An older child failing a test which results in referral at a younger age should also be referred.

[This table is from: Leffler CT. Visual impairment. In: Accardo PJ (ed). Developmental disabilities in infancy and childhood. Johns Hopkins Univ. Press. Balto., MD 2007. pp 501-520.]

Table 1 References:

American Academy of Pediatrics. Committee on Practice and Ambulatory Medicine. (1996) Vision Screening Guidelines. Pediatrics 98:156.

American Academy of Pediatrics; American Academy of Ophthalmology; American Association for Pediatric Ophthalmology and Strabismus. Screening examination of premature infants for retinopathy of prematurity. Pediatrics. 2006 Feb;117(2):572-6.
(Erratum in: Pediatrics. 2006 Sep;118(3):1324.)

Edward D.P., Kaufman L.M. (2003) Anatomy, development and physiology of the visual system. Pedatr Clin N Am 50:1-23.