Abnormalities of the optical media or alignment of the eyes during the period of visual immaturity may produce pathologic changes in the brain resulting in the clinical entity of subnormal vision known as amblyopia. Efforts to prevent visual deterioration or restore normal acuity where amblyopia exists require early diagnosis and treatment. Although amblyopia affects between 1% and 5% of children, it is estimated that at most one-fourth of preschool children are screened for this major treatable eye disorder. Simultaneous photography of the corneal and fundus reflex from both eyes using an offaxis flash photorefractor appears to be a practical, efficient, and effective method of eye-screening in pre-verbal children. Previous studies of this modality have dealt with populations referred to ophthalmology centers. We report the results of a masked validation of a commercially available photorefractor in an unselected group of children between the ages of 6 months and 6 years.