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2014 Vision Screening Guidelines
Near Vision (Hyperopia) Testing
Stephanie Grabowski, O.D.
www.nebraska.aoa.org www.nechildrensvision.org
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
2014Vision Screening Guidelines
Distance Vision TestingRequired for Kindergarten, 1st-4th, 7th and 10th gradesNo significant changes to testing procedures
Testing TipsMake sure testing distance is appropriate for the chartFor younger ages, pre-screen if necessary using larger lettersTest monocularlyObserve to make sure the child doesn’t try to cheat by peeking around the coverObserve behaviors (squinting, avoidance of covering one eye, looking around)Test each eye to threshhold
2014 Vision Screening Guidelines
Near Vision Testing (Hyperopia testing)Required for all children in the 1st and 3rd gradeReally is a test for hyperopia (farsightedness)Easily follows the distance vision testingAdds little time to the screening processRepeat distance testing with +2.50 reading flipper
Why Test for Near Vision and Hyperopia?
1. 20-25% of children ages 5 through 14 have vision problems that require professional treatment.
2. Of all vision problems, ages 6 months to 6 years, 33% are caused by hyperopia (myopia is 9.4%).
3. Of all vision problems age 6 to 18 years, 23% are caused by hyperopia (myopia is 20.2%).
4. 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.
5. 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.
6. 63% of Nebraska children entering Kindergarten were found to have hyperopia. Only 7.7% had myopia.
7. Over 19% of Nebraska children entering Kindergarten were found to have an eye condition that required the need for glasses.
Hyperopia Testing Procedure
1. Assemble the required equipment1. Eye chart with accurate floor distance measurement2. +2.50 diopter lenses or flippers3. Occluder
2. After completing the distance vision testing, instruct the child to remain in place and briefly close or rest the eyes
3. Instruct the child in the proper use of the lenses or flippers4. 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 eye5. Ask the child to read the letters on the 20/30 line6. 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.
7. Record the results8. Rescreen and notify per local school policy
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
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
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
Questions???
1633 Normandy Court, Suite ALincoln, NE 68512
(402) [email protected]
www.nechildrensvision.org
Mary Lauritzen, President
Family Vision Center Office Manager101 W. Decatur
PO Box 367 West Point, NE 68788 402-372-3266 (work)402-372-5736 (fax)
Neil Powell, NFCV Consultant
5808 Brittany PlaceLincoln, NE 68516
402-474-2242402-420-2541 fax (work)[email protected]
Stephanie Grabowski, O.D.
Family Eyecare Clinic401 N Eddy St
Grand Island, NE 68802(308)384-6922
624 Howard St St Paul, NE 68873(308) 754-5609
