The Importance of Vision Screening for Children

Vision Conditions and Student Life

Vision problems affect nearly 13.5 million children.  Rates for vision problems increase as children age…a quarter of adolescents 12-17 are reported to have eye problems”(1)

"Poor vision in childhood affects performance in school or at work and has a negative influence on the future of the child"(2)

Vision problems have been shown to adversely affect a child’s achievement in school.(3)  Myopic children have trouble reading blackboard notes or other classroom presentation materials.  Hyperopic children will have trouble reading or doing any kind of close work.  Additionally, several types of eye disorders can lead to permanent visual impairment if not identified and treated early by an eye doctor.(4)  Vision problems can and do adversely affect students’ ability to function in and enjoy learning.  What can teachers do to help children who may be struggling with a vision condition?

How to Identify a Child in Need

The following may be indicative of a child experiencing a vision problem:(5)(6)

If you have a student who is exhibiting these behaviors, it may be due to a vision problem.  It is important that you work with the child's parent or guardian to ensure that the child has an eye exam by an eye doctor.

Vision Screening: A First Step

School vision screenings are important and can help to detect eye conditions that are defined as “commonly occurring,” meaning that they occur in more than 1% of the target population.(7)  Early detection of vision problems has a demonstrated impact on quality of life for students,(8) especially in the case of color-blindness, which is often not assessed “in any other venue except as necessary for entry into certain occupations.”(9)  Although traditional school vision screenings have focused on myopia (nearsightedness, or lack of clear distance vision), children need to receive an eye exam by an eye doctor in a clinical setting that can detect issues with distance vision, close vision, color detection, and binocular vision.(10)

There is a lot of evidence demonstrating that the rates of many of these conditions are well above 1% in the population.  For example, research has shown that the rates of hyperopia,(11) myopia,(12) astigmatism,(13) amblyopia,(14) and color blindness(15) are all great enough in student populations that they pass the 1% inclusion test for vision screening.

As a first step, it is important to ensure that all students at a school have a basic visual acuity screening which is cost-effective and useful for early detection of possible vision problems. (16) 

As of April 2007, 31 states require vision screening in schools, but only Arkansas mandates that children who fail the screening must receive a full eye examination by an eye doctor.(17)  While other states “suggest” vision screening, they have no laws in place that require schools to provide vision screenings.  If your school does not have a vision screening program, you should work to implement screenings irrespective of whether or not the state requires it.  Implementing vision screenings will help to ensure that student visual issues are identified, thereby helping the students to succeed academically, athletically, and socially. Unite For Sight's North America chapters can assist a school to establish a vision screening program, and all children screened are also educated about the importance of regular eye exams by an eye doctor.

Go To Amblyopia in Children >>

Footnotes

(1) Childhood Vision: Public Challenges and Opportunities.  The Center for Health and Health Care in Schools.  Accessed 6/26/09 < http://www.healthinschools.org/Health-in-Schools/Health-Services/School-Health-Services/School-Health-Issues/Vision/Executive-Summary.aspx>

(2) S. Seema, B. Vashisht, K. Meenakshi & G. Manish : Magnitude of Refractive Errors among school children in a rural block of Haryana . The Internet Journal of Epidemiology. 2009 Volume 6 Number 2.

(3) Orfield A. Vision problems of children in poverty in an urban school clinic. Their epidemic numbers impact on learning and approaches to remediation. JOVD. 2001;32:114-141.

(4) Ferebee, Annette. (2004) Childhood Vision: Public Challenges and Opportunities: A Policy Brief.  The Center for Health and Health Care in Schools.  Accessed 6/26/09 <http://www.healthinschools.org/Health-in-Schools/Health-Services/School-Health-Services/School-Health-Issues/Vision/~/media/Files/PDF/visionfinal.ashx>

(5) US Dept. of Health and Human Services. AHRQ. Put Prevention into Practice: Child Health Guide. Publication No. APPIP 98-006. Current as of January 2003.

(6) Harris P. Learning related visual problems in Baltimore City: A Longterm program. JOVD. 2002;33:75-115.

(7) Timmreck, T. C. (2002). An introduction to epidemiology (3rd ed.). Sudbury, MA: Jones & Bartlett

(8) Pizzarello, L et. al. (1998). A school-based program to provide eyeglasses: Childsight. Journal of the American Association for Pediatric Ophthalmology and Strabismus, 2 (6), 372-374.

(9) Issue Brief: School Nursing Services Role in Health Care: School Vision Screening.  National Association of Nurses. Accessed 6/26/09 <http://www.nasn.org/Default.aspx?tabid=284>

(10) Ibid.

(11) Bullimore, M.A., & Gilmartin, B. (1997). Hyperopia and presbyopia: Etiology and epidemiology. In N.A. Sher (Ed.), Surgery for hyperopia and presbyopia (pp. 3-10). Baltimore: Williams & Wilkins.

(12) Preslan, M. W. & Novak, A. (1998). Baltimore Vision Screening Project: Phase 2. Ophthalmology, 105, 150-153.

(13) Miller, J. M., et. al. (2001). Comparison of preschool vision screening methods in a population with a very high prevalence of astigmatism [Electronic version]. Investigative Ophthalmology and Visual Science, 42 (5), 917-924. Retrieved November 14, 2004, from http://www.iovs.org.cgi/.

(14) Ferebee, A. (2004). Childhood vision: Challenge and opportunities: A policy brief. Washington, DC. The Center for Health Care in Schools, George Washington University.

(15) Evans, A. (2003b). Color is in the eye of the beholder. Auburn, CA: CVD Books

(16) Fryer, G. E., Igoe, J. B., & Miyoshi, T. J. (1997). Considering school health screening services as a cost offset: A comparison of existing reimbursements in one state. Journal of School Nursing, 13 (2), 18-21.

(17) Your State and Vision Screening: What’s the Score?  The Center for Health and Health Care in Schools.  Accessed 6/26/09 < http://www.healthinschools.org/News-Room/EJournals/Volume-8/Number-3/Your-State-and-Vision-Screening.aspx>