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Do Kids Need An Eye Exam, Or Is The School Screening Enough?

Updated: Dec 1, 2020

In Bellingham Washington, the public elementary schools will generally require (or at least, offer) a vision screening for your child up to middle school age.

What is a school vision screening?

Student reads from a snellen eye chart during school vision screening
School nurse conducting vision screening.

In the past, students would be taken out of the class, and the school nurse would line them up 20 feet away from the eye chart to check whether they can read a certain row of letters. If they weren't able to read 20/40 or so, the nurse might have given a slip to the parents to get an eye exam from an Optometrist.

However, if they could read the smallest row (usually 20/20 vision or 20/15 vision), they were given a pass. If you got a "pass", this means that you didn't need to get an eye exam.

A few years ago, the Bellingham school district changed the procedure on school vision screenings. Instead of having the child read the eye chart from 20 feet away, the began using a Welch Allyn Spot Screener, to estimate whether they'll need a prescription for nearsightedness or farsightedness.

I really like this device and I think in many cases it's accurate enough for screening purposes. It can eliminate the error that the classic screening suffered from when the child looked at the chart before the test and memorized the letters.

It also screens for abnormal drifting or eye crossing (or "strabismus"). After the device performs its function, the parent will be given a print out with "pass/fail" scores. If the child fails one category, then the parent will be notified that the child should go to an eye doctor again.


Is a School Vision Screening Really Enough?

I'll be blunt.


It is not enough.

Think about how people learn and pick up information, especially in classroom.

Use the computer? You have to use your eyes.

Read a book? You have to use your eyes.

Write? Type? Copy written information from white board? You have to use your eyes.

Watch a video? You have to use your eyes.

Phys. ed. soccer or basketball game? You have to use your eyes.

You get the idea.

Processing information through the eyes is needed all day long.

Vision is the dominant sensory system and there is more brain mass devoted to processing visual information than there is for all other senses (hearing, touch, taste and smell) combined!

It doesn't matter if a child is getting straight A's or straight F's. We can save all the students frustration throughout years of study if we just investigate how they are using their eyes to gather information.

Seeing 20/20 or passing the test from the new handheld device is great. We all want the children to see clearly, but that's not enough.

So whether your child is struggling or they are an academic superstar, it's important to bring them to an Optometrist for a more thorough eye exam.

This is probably sounding self-serving. I know. I'm an optometrist telling parents they should get their kids' eyes checked with an Optometrist. But it is truly important.

Vision problems can affect development, motor skills, balance, coordination, reading, writing, and cause headaches, fatigue, and frustration for kids leading to behavior issues and attention problems.

Vision problems can make the straight A student have to work twice as hard. Vision problems can make a child feel stupid, when they know they are capable.


Get A Comprehensive Eye Exam

Taking your child in for a comprehensive eye exam will help determine if they have the visual skills necessary to thrive in school.

Visual skills such as:

Accommodation: The ability to shift focus from distant to near objects and sustain focus.

Binocular Vision: The ability to keep the eyes steady together as a team.

Eye Tracking: The ability to follow moving objects or quickly move the eyes from one spot to another.

Your eye doctor will also check to see if the child needs reading glasses, bifocals, "all day" glasses or has any eye health problems that could be sight threatening.

In the next article I will write about how sometimes the comprehensive eye exam falls short of checking all the visual skills necessary for school success. If you are interested in a more thorough vision evaluation than the standard eye exam, click here to learn about visual motor and visual perceptual testing.

Have you ever been surprised that an Optometrist or Ophthalmologist identified a vision problem that wasn't caught through a screening? Comments are welcome below.

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