CHILDREN'S VISION · CONCORD EYECARE
Your child's StEPS result — what now?
Got a referral letter from your child's preschool vision screening? We'll explain what it means and what to do next. No GP referral needed. Bulk-billed.
Book a Children's Eye Test (02) 8765 9600Reviewed by Dr Mark Joung, B.Optom (Hons) UNSW · Last updated May 2026
STEPS VISION SCREENING
What is the StEPS vision screening?
A free NSW Health program for every 4-year-old
StEPS is a screening — not a full eye test. It checks one thing: whether your child can read letters at a set distance with each eye. If the screener finds a possible issue, you'll receive a referral letter in your child's preschool bag recommending a follow-up eye test with an optometrist.
Around 1 in 5 children screened through StEPS are referred for further assessment. That sounds like a lot — but it includes borderline results, shy children who struggled in the screening environment, and genuine vision issues that need attention.
SCREENING VS FULL EYE TEST
What does StEPS actually test — and what doesn't it check?
A screening checks one thing. A proper eye test checks everything.
StEPS Screening Checks
Comprehensive Eye Test Also Checks
This is why we recommend a comprehensive eye test for all children before starting school — even if they've passed their StEPS screen. We regularly see children who passed their screening but had issues with focusing, eye teaming, or early myopia that the screening wasn't designed to detect.
AFTER THE STEPS REFERRAL
My child was referred after StEPS — what happens next?
Don't panic. This is exactly what the program is designed to do.
A StEPS referral doesn't mean your child definitely has a vision problem. Sometimes children are referred because they were shy or distracted during the screening — a time-pressured environment where dozens of kids are being tested in quick succession. That can produce a "fail" that doesn't reflect their actual vision.
Other times, the screening picks up a genuine issue — most commonly a refractive error (long-sightedness, short-sightedness, or astigmatism) that wasn't apparent to parents because the child had never complained.
During your child's appointment, we'll do a thorough assessment covering everything StEPS couldn't — near vision, eye coordination, tracking, colour vision, and eye health. We complete the StEPS feedback form for you and return it to the program, so your child's records stay up to date.
PASSED STEPS?
What if my child passed their StEPS screening?
Passing is good news — but it doesn't mean everything's fine.
A pass means your child's distance vision met the threshold in both eyes on the day of screening. That's reassuring. But StEPS doesn't check how well your child focuses up close for reading, whether their eyes work together as a pair, or whether conditions like myopia are developing.
We recommend all children have a comprehensive eye test before starting school — ideally at age 4, and then annually from age 6 onwards. This is especially important if there's a family history of glasses, lazy eye, or eye conditions. Medicare covers children's eye tests at no cost, and you don't need a GP referral.
If you'd like to know more about the signs that your child might need glasses, we've put together a guide for parents covering what to watch for at different ages.
FREQUENTLY ASKED QUESTIONS
StEPS screening — common questions from parents
Do I need a GP referral to see an optometrist after StEPS?
No. You can book directly with an optometrist — no GP referral is required. Just bring your child's StEPS referral letter and feedback form to the appointment.
Is the follow-up eye test covered by Medicare?
Yes. Children's eye tests are bulk-billed through Medicare, so there's no out-of-pocket cost for the consultation. If your child needs glasses, that's a separate cost — we'll discuss options and pricing with you at the appointment.
What if my child was too shy or couldn't do the StEPS test?
This happens more often than you'd think. Some children find the screening environment overwhelming. If your child was marked "unable to be screened," we'd still recommend a comprehensive children's eye test. We have more time, and a calmer one-on-one setting often makes all the difference.
Does StEPS check for colour vision problems?
No. StEPS only tests distance visual acuity — it doesn't screen for colour vision deficiency, which affects around 8% of boys. We include colour vision testing as part of every children's eye test, and it's especially important to identify before school starts.
What if myopia is found at my child's follow-up eye test?
If your child is found to be short-sighted, we'll discuss whether myopia control is appropriate. There are now several evidence-based options — special lenses, eye drops, and overnight contact lenses — that can slow progression during the critical growth years. The earlier myopia is detected, the more options are available.
When should my child have their next eye test after StEPS?
We recommend annual eye tests from age 6 onwards — that's when vision demands increase with school and when conditions like myopia commonly begin developing. If any issue was found at the StEPS follow-up, we'll advise a specific review schedule.
SOURCES
References
1. NSW Health. Statewide Eyesight Preschooler Screening (StEPS) Policy Directive. PD2018_015. health.nsw.gov.au
2. Robaei D, Kifley A, Mitchell P, et al. Vision Screening in Children: The New South Wales Statewide Eyesight Preschooler Screening (StEPS) Program. Ophthalmol Sci. 2022;3(1):100234. 564,825 children screened; 19.2% referral rate.
3. NSW Health. Statewide Eyesight Preschooler Screening (StEPS). health.nsw.gov.au/steps
4. Optometry Australia. Clinical Practice Guide for Paediatric Optometry. Recommends comprehensive eye examination for all children prior to school entry.
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Your child's vision matters.
No referral needed. Bulk-billed. Appointments Monday to Saturday.