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1
Vision Screening Guidelines:Birth – Five Years
Tanni Anthony
Colorado Department of Education
Part B Teleconference Series
February 2007
2
TRAINING GOALS
Provide vision screening that is developmentally appropriate.
Establish best practices across the state for system consistency.
3
SCREENING SHOULD
Be economical
Be easy to complete by trained personnel
Answer the simple question of whether there is or not a vision concern.
Proceed any other developmental evaluation of the child.
4
SCREENING SHOULD NOT
Be used as an opportunity to infer any type of medical diagnosis.
The role of the screener is to simply determine whether a next step evaluation is needed for more information.
5
Vision Screening Manual 0-5
http://www.cde.state.co.us/early/downloads/early_vision_manual.pdf
The manual and the protocol forms can be downloaded (the latter in word format so they can be customized for district use).
The manual was finalized in January 2005.
6
Vision Screening Kits
At least one kit per Child Find team were disseminated in 2002-03
Funded by Colorado Services to Children with Deafblindness (a one time gift!).
Items: penlight, 2 monster caps, small toys, slinky, black foam sheet, cake decorations, fixation occluder, tape measure, tin, and Lea symbol test.
8
Components of 0-5 Visual Screening
Reviewing Intake History For High Risk InfoVisual Inspection of the Eyelids/ EyesPupillary ConstrictionAlternate Cover and/or Corneal Light TestFixation / Tracking / ConvergenceVisual AcuityCompensatory Visual Behaviors
9
REVIEWING HISTORY (p. 6)
Information about the child’s medical and developmental history should be available from the Child Find intake information.
If not, there is a form in Appendix A for gathering information specific to a family history/child history as they pertain to vision.
11
Appearance of Eyelids / Eyes (p. 9-10)
MANY VISUAL PROBLEMS ARE VISIBLE.
Look at the child’s face and eyes.
Is there any evidence of asymmetry, unusual irritation, tearing, eye crossing, etc.
20
Pupillary Constriction (P. 8-9)
Practice with your penlight.
Do not direct the beam into the child’s eyes. Center the beam at forehead level.
Look for brisk and bilateral constriction with light. Dilation with light removal.
21
Alternate Cover (p. 10-11)
Turn to page 10 in manual and follow instructions to practice with your partner.
Equipment: a fixation toy and the occluder.
22
This is an important test to practice
Check out the video tape for the 1991 School Nurse Vision Screening Guidelines – look for the tape section on redress movement. This is a classic example of what to look for.
24
Practice with Penlight
Have child (your colleague!) look straight ahead at the fixation paddle.
Shine a light at forehead level and look at reflection in both eyes.
26
Eye Teaming Tasks (P. 11-13)
Near fixation with cake decoration pellet and black foam sheet.
Horizontal and vertical tracking with penlight/monster caps or frog finger puppet.
Convergence with fixation stick, frog finger puppet, and/or penlight with monster caps.
27
Lea Symbol Cards (P. 13-14)
For 2.5 years and older (if able)
Practice with set of cards
Remember to double the denominator if you screen from 10 feet.
28
Compensatory Behaviors (p. 14)
Complete after screening.
Notice any unusual body posturing and/or eye behaviors (squinting, blinking, eye rubbing, etc.)
29
Scoring the Screening Tool (P. 16)
Find and discuss the three outcomes.
Pass = no problems observed / reported
Re-screen = screener would like another chance to screen the child on another day.
Fail = refer to the next step medical specialist (based on family’s insurance etc.)
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