School Vision Screenings

Eye examination
A student eye examination. National Eye Institute, National Institutes of Health

As a concerned parent, you want your child to perform well at school. As you prepare your child for each new school year, make sure you don't forget one of the most important school supplies -- good vision. The American Optometric Association warns that school vision screenings may not accurately measure your child's overall eye health.

Even though a good part of learning is visual, the only eye test many children receive is a vision screening at school.

Most schools try to do a good job of evaluating students' vision, but a screening is not intended to replace a thorough, professional eye exam. A professional eye examination is performed by an eye doctor and can reveal serious eye conditions and diseases.

School vision screenings are designed to check a child's eyesight, sharpness of vision or presence of a refractive error. Students' distance vision is usually measured, which may reveal nearsightedness. But a screening usually fails to check a child's close-up skills needed for reading, such as tracking, focusing, and binocular vision. Considering that most school work is performed at arm's length, students who have trouble seeing close-up will not be able to reach their full learning potential.

Performing well at school can be very difficult if a child has visual problems. The American Optometric Association recommends having your child's eyes examined at the ages of 6 months, 3 years and 5 years, and then every other year while the child is in school.

If you follow these guidelines, the school vision screening should be an important safety net, alerting you to possible problems as they develop.

Comprehensive Eye Exam vs Vision Screening

A vision screening, in most cases, is nothing more than having a child read the smallest line they possibly can on an eye chart.

While the school nurses are highly trained professionals, people that conduct vision screenings may not always be adequately trained. Furthermore, a vision screening is usually a measure of central visual acuity and other testing is limited. Your eyes are an extension of your neurological system and vision testing encompasses many different visual systems.

Specialized equipment is needed to perform a professional, comprehensive eye examination and can only be conducted by an ophthalmologist or optometrist who has the training and education to fully evaluate a child's vision and eye health. 

A comprehensive, medical eye exam includes the following elements:

  • Comprehensive review of medial history
  • Visual acuity measurements with and without glasses at distance and near
  • Neurologic confrontation visual field tests
  • Extraocular muscle testing
  • Bincular vision testing
  • Color vision testing
  • Evaluation of focusing ability
  • Pupillary measurements and testing
  • Eye pressure tests
  • Objective and subjective measurement of refractive state
  • Microscopic examination of the front part of the eye
  • Dilating and sometime cycloplegia eye drops
  • Microscopic examination of the back part of the eye including the retina
  • Professional assessment and plan

Although vision screening programs do catch the bigger vision problems, many vision problems are not detected. Just because a child passes a simple vision screening, you can not assume that their eyes are healthy and vision is perfect. A vision screening is no substitute for a comprehensive eye health and vision examination.

Source: American Optometric Association. School Vision Screenings. 01 Aug 2007.

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