2014 Vision Screening Guidelines

1. 2014 Vision Screening Guidelines Near Vision (Hyperopia) Testing

2. Stephanie Grabowski, O.D. • www.nebraska.aoa.org • www.nechildrensvision.org

4. Vision Screening – used to make a general categorization of those being examined (i.e. school screenings) • Vision Assessment – use of a series of defined tests to draw inferences about the health and function of the visual system (i.e. See to Learn) • School Vision Evaluation – required of all Kindergarten and students new to the school system prior to entering school. • OD, MD, PA, APRN • Visual Acuity, Amblyopia, Strabismus, Internal and External Health • Comprehensive Vision Evaluation – series of tests and observations used to measure the health and function of an individual’s visual system

5. 2014Vision Screening Guidelines • Distance Vision Testing • Required for Kindergarten, 1st-4th, 7th and 10th grades • No significant changes to testing procedures • Testing Tips • Make sure testing distance is appropriate for the chart • For younger ages, pre-screen if necessary using larger letters • Test monocularly • Observe to make sure the child doesn’t try to cheat by peeking around the cover • Observe behaviors (squinting, avoidance of covering one eye, looking around) • Test each eye to threshhold

6. 2014 Vision Screening Guidelines • Near Vision Testing (Hyperopia testing) • Required for all children in the 1st and 3rd grade • Really is a test for hyperopia (farsightedness) • Easily follows the distance vision testing • Adds little time to the screening process • Repeat distance testing with +2.50 reading flipper

7. Why Test for Near Vision and Hyperopia? 20-25% of children ages 5 through 14 have vision problems that require professional treatment. Of all vision problems, ages 6 months to 6 years, 33% are caused by hyperopia (myopia is 9.4%). Of all vision problems age 6 to 18 years, 23% are caused by hyperopia (myopia is 20.2%). Less than 50% of the children with a clinically significant visual disorder will be identified by the use of a distance visual acuity test alone. 4th and 5th graders spend 54% of their time on near point reading and writing tasks. An additional 21% is spent on near to far tasks. 63% of Nebraska children entering Kindergarten were found to have hyperopia. Only 7.7% had myopia. Over 19% of Nebraska children entering Kindergarten were found to have an eye condition that required the need for glasses.

8. Hyperopia Testing Procedure • Assemble the required equipment • Eye chart with accurate floor distance measurement • +2.50 diopter lenses or flippers • Occluder • After completing the distance vision testing, instruct the child to remain in place and briefly close or rest the eyes • Instruct the child in the proper use of the lenses or flippers • Have the child hold the +2.50 diopter lenses or flippers in front of both eyes or the eye to be tested and occlude the other eye • Ask the child to read the letters on the 20/30 line • Correct recognition of more than half the letters on the 20/30 line, viewed through the +2.50 diopter lenses or flippers constitutes a non-passing result. • Record the results • Rescreen and notify per local school policy

10. REMEMBER: If the child easily reads the 20/30 line they FAIL If the child struggles to read or cannot read the 20/30 line they PASS

12. Recommended Additional Testing • Stereopsis • Used to determine if the two eyes are working together • A child who doesn’t pass the stereopsis test is a risk for developing amblyopia (lazy eye) • Recommended for ages 3 through 9 • Random Dot E cards

13. Recommended Additional Testing • Color Vision • Used to detect a suspected color deficiency in a child • Usually initiated by the teacher or parent • Important to know for learning as some tasks can be color coded • Color deficiencies are typically more common in boys • Can screen binocular

14. Questions???

15. 1633 Normandy Court, Suite A Lincoln, NE 68512 (402) 474-7716 noa@assocoffice.net www.nebraska.aoa.org

16. 1633 Normandy Court, Suite A Lincoln, NE 68512 (402) 474-7716 nfcv@assocoffice.net www.nechildrensvision.org Mary Lauritzen, President Family Vision Center Office Manager 101 W. Decatur PO Box 367 West Point, NE 68788 402-372-3266 (work) 402-372-5736 (fax) marydv@cableone.net Neil Powell, NFCV Consultant 5808 Brittany Place Lincoln, NE 68516 402-474-2242 402-420-2541 fax (work) Npowell002@neb.rr.com

17. Stephanie Grabowski, O.D. Family Eyecare Clinic 401 N Eddy St Grand Island, NE 68802 (308)384-6922 624 Howard St St Paul, NE 68873 (308) 754-5609 drgrabowski@fecvision.com www.fecvision.com