Schools - Current Vision Assessments

Manual Vision Screening

Typically, vision screenings are performed manually, using some type of matching game. This method requires trained personnel to administer the screening. The requirement for huge numbers of trained personnel creates a logistical barrier for mass screenings. Furthermore, the lack of standardization among different screeners raises concerns over accuracy and consistency.

Photoscreening

Recently, photoscreening (photographing the eye’s red reflex) has been proposed as an alternative way of evaluating for vision problems in children. In theory, photoscreening allows testing of very young or developmentally impaired children who could not otherwise cooperate with manual screening techniques. Unfortunately, photoscreening does not check the child’s vision. Photoscreening can only check for certain eye conditions which might impair vision. In addition, photoscreening requires expensive, specialized equipment and large numbers of trained personnel both to perform and interpret the testing. These limitations make photoscreening less desirable for use with children old enough to read an eye chart. Furthermore, on the spot interpretation of results is often not accurate. Offsite, professional interpretation improves accuracy but delays results, adds expense, and makes coordinating medical referrals difficult.

Full Eye Examination

The third method to check a child’s vision is a professional examination in an eye doctor’s office. Although a full examination has the potential to be the most thorough method of screening for eye problems, it is not performed in the schools. Many children are unable to visit an eye doctor’s office. Even if it were logistically possible for every child to visit an eye doctor’s office, the costs would be overwhelming. Furthermore, not all eye doctors are trained the same. The lack of a standardized child’s eye examination makes even this most expensive proposition subject to accuracy and reliability concerns.

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