Pediatric Eye Exam Referrals for Pediatricians in Boca Raton.
For pediatricians, family physicians, nurse practitioners and their staff. When a screening is failed, inconclusive or impossible, we see the child for a full exam and send the findings back to you. Opening November 16, 2026.
A Screening Finds the Question. An Exam Answers It.
You already do the hard part. The AAP's policy statement, written with the AAO, AAPOS and the certified orthoptists, asks pediatricians to examine the eyes from the newborn nursery through adolescence, to start instrument-based screening between 12 months and 3 years when it is available, and to begin direct acuity testing around age 4.[1]
The same statement says children with an ocular abnormality, or who fail a vision assessment, should be referred to a pediatric ophthalmologist or an eye care specialist appropriately trained to treat pediatric patients.[1] That second step is where I come in.
I'm Dr. Christina Murray, OD, FOVDR, and pediatric and developmental eye care has been the center of my work for more than ten years. A screening tells you a child might have a problem. A comprehensive exam is different: it tells the family what the problem is and what to do about it.
Referral Criteria by Age
The American Academy of Ophthalmology's pediatric guideline lays out which screening methods fit which ages, and the result that should prompt a referral. It is adapted from the AAP's Bright Futures guidelines.[2]
- Every age, newborn on: refer for a red reflex that is absent, white, dull, opacified or asymmetric; a structural abnormality such as ptosis; or pupils that are irregular, unequal or react poorly.[2]
- From about 3 months: failure to fix and follow, or an asymmetric or displaced corneal light reflex.[2]
- From 12 months (or 6 months in a cooperative infant): an instrument-based screen that does not meet its screening criteria. The AAP advises repeating it at annual well-child visits until acuity can be tested directly.[1],[2]
- Ages 3 to 4: worse than 20/50 in either eye, a 2-line difference between the eyes, or a refixation movement on cover testing.[2]
- Age 4 and up: worse than 20/40 in either eye, or a 2-line difference between the eyes.[2]
- Inconclusive: retest within 6 months. If it is still inconclusive, or retesting cannot be done, refer.[2]
What Instrument Screeners Are Built to Catch
AAPOS updated its targets for photoscreeners and autorefractors in 2021. Devices are validated against an exam that finds anisometropia over 1.25 D, hyperopia over 4.0 D, media opacity over 1 mm, and manifest strabismus over 8 prism diopters. Before 48 months the targets include astigmatism over 3.0 D and myopia beyond -3 D; after 48 months, astigmatism over 1.75 D and myopia beyond -2 D.[3]
AAPOS notes that after age 4, the lower myopia and astigmatism targets matter less for amblyopia and more because they can affect school performance and may warrant consideration of myopia management.[3] Your device's own referral settings come from its manufacturer, so a "refer" result from the device is the trigger, not these numbers.
Screening continues after kindergarten too. The AAPOS and AAO joint statement recommends screening every 1 to 2 years after age 5, and a comprehensive eye exam for children with possible or diagnosed learning disabilities.[4]
Findings That Should Not Wait
Some findings need same-day or urgent evaluation, and several belong with pediatric ophthalmology or the emergency department rather than a routine eye exam slot:
- White pupil (leukocoria), or an absent, dull or asymmetric red reflex. The AAO and AAPOS say any baby with an abnormal red reflex requires urgent consultation.[4] Causes include cataract, retinal detachment, retinopathy of prematurity, infection inside the eye, Coats disease and retinoblastoma, and AAPOS says the child should see an eye doctor right away.[5]
- New or sudden nystagmus, which requires urgent evaluation.[6]
- A dilated pupil with limited eye movement, an urgent referral to evaluate for a third nerve palsy.[6]
- Tearing with light aversion and an enlarged or cloudy cornea, an immediate referral for possible congenital glaucoma.[6]
- A constant eye turn in an infant older than 3 months, which should be evaluated promptly.[6]
- Eye injuries, chemical splashes and sudden vision loss. See our urgent eye care page and the parent guide to what to do after a child's eye injury.
For urgent problems we can typically see a patient the same day or direct them to an emergency room if needed. If you are unsure where a child should go, call us at (561) 462-1245 and we will help you decide.
What Your Patients Get Here
Comprehensive Pediatric Eye Exams
Acuity at distance and near, eye health, teaming and tracking, focusing, color vision, and refraction, adapted to the child's age.
Binocular Vision Evaluations
Amblyopia, strabismus, convergence insufficiency, double vision, and post-concussion vision symptoms.
Amblyopia (Lazy Eye)
Diagnosis and follow-up for a child with reduced vision in one eye.
Myopia Management
MiSight 1 day lenses, orthokeratology, and low-dose atropine to slow progression in nearsighted kids.
Glasses and Contact Lenses
Kids' frames and fitting, plus contact lenses when a child is ready.
Urgent Eye Care
Red eyes, eye injuries, foreign bodies, and infections, often seen the same day.
Two doctors see patients here: Dr. Christina Murray, OD, FOVDR, whose focus is pediatric and binocular vision care, and Dr. Jeannine Gutierrez, OD, who provides primary eye care for every age. For school nurses and teachers, we keep a separate page for schools. For children whose concern is eye teaming, tracking or vision-related learning difficulty rather than eyesight, our sister practice has referral information for pediatricians as well.
Four Steps, One Loop
Send the Referral
Email referral@pedsfamilyvision.com or call (561) 462-1245. Include the reason for referral, the screening result, and how you would like to receive our findings.
We Schedule the Family
We coordinate scheduling with the family, or they can book online in about a minute.
Comprehensive Exam
A full exam, adapted to the child's age, with a binocular vision evaluation when the concern calls for one.
Findings Sent Back
We follow up with a report to your office after the evaluation, so the plan lives in the medical home too.
Insurance, Language, and Hours
- Insurance: we bill vision and medical insurance and verify benefits before the visit. Plan details are on our insurance page.
- Spanish-speaking families: our site is available in Spanish at pedsfamilyvision.com/es.
- Hours: Monday – Friday: 8:30 AM – 5:30 PM. Saturday: Closed. Sunday: Closed.
- Opening: November 16, 2026.
- Referrals: referral@pedsfamilyvision.com or (561) 462-1245.
Questions From Referring Offices
Do you accept referrals straight from a failed screening, before a formal diagnosis?
Yes. A failed or inconclusive screening is exactly when a referral makes sense. The AAP policy statement says children who fail a vision assessment should be referred to a pediatric ophthalmologist or an eye care specialist appropriately trained to treat pediatric patients. Send it to referral@pedsfamilyvision.com or have the family book online. Parents can read what happens after a failed vision screening.
What acuity result should trigger a referral?
Per the AAO Pediatric Eye Evaluations guideline, refer a 3 to 4 year old who sees worse than 20/50 in either eye, and a child 4 or older who sees worse than 20/40 in either eye. At any age, a difference of 2 lines or more between the eyes is also a referral.
What if the child will not cooperate with screening?
The AAO guideline says to retest within 6 months. If the retest is still inconclusive, or the child cannot be retested, refer for a comprehensive eye evaluation. In my practice we examine babies and toddlers using methods that do not depend on reading letters. See our toddler eye exams page.
Which findings should not wait for a routine appointment?
A white, dull, absent or asymmetric red reflex needs urgent evaluation, because causes include cataract and retinoblastoma. New or sudden nystagmus, a dilated pupil with limited eye movement, and tearing with light aversion and a cloudy or enlarged cornea are also urgent. Many of these belong with pediatric ophthalmology the same day. If you are unsure, call us and we will help you decide.
Will you send findings back to our office?
Yes. After the evaluation we follow up with a report to the referring office, so the medical home has the findings and the plan. Include your preferred way to receive it with the referral.
Where This Information Comes From
- Donahue SP, Nixon CN, et al. "Visual System Assessment in Infants, Children, and Young Adults by Pediatricians." Pediatrics. 2016;137(1):28-30 (AAP policy statement, with AAO, AAPOS and AACO)
- American Academy of Ophthalmology. Pediatric Eye Evaluations Preferred Practice Pattern (2022), Table 1: Age-Appropriate Methods for Pediatric Vision Screening and Criteria for Referral: adapted from Bright Futures, 4th ed.
- Arnold RW, Donahue SP, et al. "AAPOS Uniform Guidelines for Instrument-Based Pediatric Vision Screen Validation 2021." J AAPOS. 2022;26(1):1.e1-1.e6
- AAPOS and American Academy of Ophthalmology. "Vision Screening for Infants and Children" (joint policy statement, 2022)
- American Association for Pediatric Ophthalmology and Strabismus. "Leukocoria"
- Children's Hospital of Orange County (CHOC). Pediatric Ophthalmology Referral Guidelines
Serving Boca Raton and Nearby Cities
We see patients for pediatric eye exams referred by local pediatricians at our office at 1000 NW 9th Ct, Ste 203A, Boca Raton, FL 33486. Families also come to us from Delray Beach, Highland Beach, Boynton Beach, Deerfield Beach, Parkland, Coral Springs, and Pompano Beach. Directions from your city →
Refer a Patient
Send referrals to referral@pedsfamilyvision.com, call (561) 462-1245, or have the family book online.