The vision screening program has a long and interesting history involving educators, pediatricians, optometrists, and ophthalmologists. Since, the earliest screening program initiated in 1899, many alterations in the original program have resulted from consideration of test reliability, testing conditions, and child maturity. Indeed, even the basic concept of vision screening had to be proven beneficial before it was widely accepted. The three basic areas of the exam - visual acuity, hyperopia, and heterophoria - developed independently into a concise, thorough screening system. Minor controversies continue, causing continuing modification and improvement.