Which of the following is a condition that would require immediate referral after screening?

Excessive hyperopia, or significant farsightedness, requires immediate referral after screening because it can lead to various complications if left unaddressed. This condition can impair visual development, particularly in children, and is associated with difficulties in focusing on nearby objects, leading to potential learning challenges and eye strain. Early detection and management of excessive hyperopia are crucial to prevent long-term vision issues and enhance a child's ability to perform visual tasks effectively.

In contrast, normal vision with no symptoms does not indicate the need for referral as it signifies that the individual does not have any visual impairments. Minor eye strain and temporary discomfort, while they may cause inconvenience, are generally not urgent conditions requiring immediate attention and can often be resolved with simple measures or further observation rather than through referral to a specialist. Thus, excessive hyperopia stands out as a condition that necessitates prompt intervention.