Clinical Cheatsheets

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A peek at the pediatric norms — unlock every category with Plus.

Referral red flag: VA worse than expected age threshold or interocular difference ≥ 2 lines.

Persistent tropia after 4 months is abnormal and needs urgent evaluation.

IOP > 21 mmHg needs glaucoma workup; crying and squeezing can falsely elevate values.

Use cycloplegic refraction thresholds together with age, symptoms, and amblyopia risk.

Age	Snellen	logMAR	Preferred Method	Notes
Birth – 1 mo	20/400 – 20/800	1.3 – 1.6	PL / FPL	Optokinetic response present
2 – 3 mo	20/400 – 20/200	1.0 – 1.3	FPL / VEP	Social smile & fixation
4 – 6 mo	20/200 – 20/100	0.7 – 1.0	FPL	Reaches for objects
6 – 12 mo	20/100 – 20/50	0.4 – 0.7	FPL / Cardiff	Crawling; binocularity developing
1 – 2 yr	20/60 – 20/40	0.3 – 0.5	Cardiff / HOTV
2 – 3 yr	20/40 – 20/30	0.2 – 0.3	HOTV / LEA	Matching cards; cooperation variable
3 yr	20/40	0.3	HOTV / Allen	Referral threshold: < 20/50 or ≥ 2-line interocular diff
4 yr	20/30	0.2	HOTV / Snellen E	Referral threshold: < 20/40
5 yr	20/25	0.1	HOTV / Snellen	Referral threshold: < 20/30
6+ yr	20/20	0.0	Snellen	Adult threshold

Referral criteria (AAP/AOA): VA < 20/50 at age 3, < 20/40 at age 4-5, or ≥ 2-line interocular difference at any age.

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