State guidelines vary. In some states, schools use Snellen Visual Acuity as the sole test during screening. With this minimal evaluation significant vision problems which could affect visual comfort, efficient performance, reading and learning will go undetected. Some states have attempted to revise and improve school screening guidelines. These efforts are typically hampered by budget limitations, time constraints and disagreement concerning what vision problems should be tested. Schools are often forced to take a conservative posture. If they screen too thoroughly, they are criticized for over-referral.
Passing the school vision screening does not guarantee the absence of a vision problem; and failure does not ensure that the eye care practitioner will address the visual problem suspected from the screening. Many eyecare practitioners do not routinely test for visual information processing and binocular dysfunction even though these appear to be related to efficient performance in the academic environment.
School vision screenings will remain an important safety net for many children, but these screenings may occur too late for early detection of many serious eye or vision problems. Prevention of vision problems and their consequences require timely detection. The College of Optometrists in Vision Development recommends that all children receive a thorough professional eye and vision examination, particularly one that includes a comprehensive assessment of visual information processing and binocular function. As recommended by the American Optometric Association, all children should have their first vision examination by six months of age and periodically thereafter prior to entering school to monitor vision development. School vision screening can not stand alone as the only investigation of visual function for school-aged children.
Members of the College of Optometrists in Vision Development (COVD) are optometrists with a special interest in vision development and are skilled in providing comprehensive vision care for children. Fellows of the College have certified their competency in this area. For further information contact COVD or consult with your COVD optometrist.
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