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Seeing Clearly: Vision Screening FAQ

Ensuring students are in the best physical and mental condition to achieve academic success is at the core of every school nurse's practice. One way to accomplish this is through school vision screenings, which can detect potential vision impairments affecting a student's learning and participation in the classroom and beyond. But preparation in basic nursing education doesn't always appropriately equip the school nurse with the knowledge and expertise necessary to perform quality vision screenings. Additionally, protocols on how and when screenings should be conducted in schools vary widely from state to state. To help gain some clarity, we've compiled and answered some of the most frequently asked questions about school vision screenings. 

Why do school vision screenings?

School vision screenings are important because they help identify any potential vision problems early. By detecting these issues early, appropriate interventions can be implemented to address them and ensure that students have the best chance for academic success and optimal well-being. Additionally, vision screenings can help detect certain eye conditions with no apparent symptoms, such as amblyopia or strabismus, which can lead to more serious vision problems if left untreated. 

What are vision screenings "testing"?

School vision screenings are not comprehensive eye exams but can act as preliminary checks for things like visual acuity (near and far), stereoacuity, refractive error, eye muscle coordination, and color vision. To check which types of screenings are required in your state, click HERE.

 What do the numbers mean when measuring visual acuity?

When measuring visual acuity, the numbers represent the level of clarity a student can see at a certain distance. The standard measurement is 20/20, which means that a student can see letters or objects from 20 feet away, that a student with normal vision can also see from that distance. If someone has 20/40 vision, it means they can see at 20 feet what a student with normal vision can see at 40 feet.

 What grades/ages should be screened?

Every state has different requirements for the age and grades of students who require school vision screenings. To check your state's requirements or best practice guidelines, click HERE.

 What type of equipment is required?

Having the right equipment is crucial for ensuring accurate school vision screenings. Every state has different requirements and protocols associated with vision screening equipment. To check your state's requirements or best practice guidelines, click HERE.

What is an optotype?

An optotype is a standardized symbol on an eye chart, such as a letter, number, or shape, used during vision testing to measure a student's visual acuity. See which optotypes are recommended in your state HERE.

What is the difference between “threshold screening” and “critical line screening”?

Critical line and threshold screening are the two main methods of testing distance visual acuity. Critical line vision screening involves testing a student's ability to see small lines and shapes at a certain distance, while threshold vision screening involves gradually reducing the size of letters on a chart until the student can no longer read them. Check your state's guidelines or best practices for which method you should use HERE.

What is instrument-based screening?

Instrument-based screening uses automated technology to evaluate the structure of the eye for the presence of the following amblyogenic factors in one or both eyes: refractive errors, eye misalignment, and media opacities.

 What are some resources for affordable or free comprehensive eye exams and eyeglasses?

Eye care can be expensive, but some programs offer free or low-cost accessibility to eye exams and eyeglasses. VSP Eyes of Hope partners with NASN members to offer no-cost vision support for qualifying students. Your local Lions Club International may also help pay for eye care or prescription products. New Eyes is a non-profit dedicated to getting eyeglasses to kids in need. Prevent Blindness has a complete directory of financial assistance programs for eye care.

State Specific Vision Guidelines can be found HERE. Shop all vision screening supplies HERE.

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