The goal of childhood vision screening is to identify children who have subnormal vision or are at risk for poor visual development, at an early enough age to allow for effective treatment. Neuroplasticity in visual development declines during childhood, resulting in decreasing treatment effect with age. Many children have unrecognized risk factors for eye disease, and ocular abnormalities can sometimes indicate systemic disease. Children with visual difficulties do not always have symptoms or complaints. For these reasons, periodic childhood vision screening remains an essential component of health maintenance. A commitment on the part of physicians, schools, and communities is needed to detect ocular pathology and decreased vision in children.