Material and Method: Seven hundred seventy five pre-school participated where 389 subjects were boys and 386 subjects were girls were tested using the Lea Symbols chart and the Sheridan Gardiner chart. The mean age of the pre-school children was 5.3 + 0.7 years old.

Results: The Lea Symbols chart showed a higher sensitivity (97.5%) compared to the Sheridan Gardiner chart (57.1%). While the Sheridan Gardiner chart showed higher specificity (92.0%) compared to the Lea Symbols chart (45.0%).

Conclusion: The Lea Symbols chart offers a better pick-up rate of visual impairment during a vision-screening program especially cases of amblyopia among pre-school children compared to the Sheridan Gardiner chart in Malaysia.

Keywords: Pre-school children, Visual impairment, Amblyopia, Lea Symbols chart, Sheridan Gardiner chart