Education Health: Vision Screening Guidelines for School Nurses

Waiting until a child can read a Snellen wall chart means we lose several early years of vision screening opportunities. The recent vision screening guidelines of the American Academy of Pediatrics confirms it is a false economy to wait that long. Using a vision screener provides a better chance of catching amblyopia that could otherwise result in lazy eye. Not to mention other systemic diseases that can lead to visual impairment if left unchecked.

Vision Screening Guidelines by California Education Department

The California Guide for Vision Testing in Public Schools opens by saying “our ability to see greatly impacts our ability to learn”. Back in 1947, the state passed a law that schools must do vision screening at prescribed grade levels. The California vision screening guidelines provide detail at Page 18 concerning procedures for vision testing non-literate, non-verbal, non-English-speaking, very young children, and children with special needs.

In the case of pre-school testing, students may have short attention spans, limited verbal capability, immature eye-hand coordination, disabilities hindering responses, or perhaps just fear of new situations. The California vision screening guidelines require that school nurses give young children and children with special needs particular attention. They should invite parents/caretakers/guardians to attend the test to facilitate a calming environment.

Furthermore, the California Education Department suggests that vision testing of young children or children with special needs should be conducted using methods and equipment suitable to a child’s developmental level. This must be compatible with the cognitive assessment tool. Where this is not practical, the teacher may use functional testing, for example, using the Illiterate E Chart.

Involving Parents Early With Vision Screening Guidelines

Parents have a right to know, in advance of any medical attention affecting their children. The National Association of School Nurses believes a ‘strong vision health system of care’ begins with the distribution of culturally appropriate vision screening guidelines to parents on the first day of school.

Nurses can consider a short, interactive seminar towards the end of the first semester. When the teacher posts a note of an upcoming eye test, the parents are onside because the vision screening guidelines already made them aware why testing young eyes is so crucially important.

When explaining their vision screening guidelines to parents/caretakers/guardians, school nurses should also ask them to agree on a joint HIPAA/FERPA release so they can share a child’s personal information with appropriate healthcare providers. Here’s a useful link explaining the Health Insurance Portability and Accountability Act (HIPAA) and Family Education Right and Privacy Act (FERPA)


These vision screening guidelines assist a school nurse to use appropriate eye test technology, thereby affording a child the best prospect of seeing clearly, and the best opportunity to learn. Vision screening results can ultimately assist in preventing and treating eye problems in children. However, the actual methods used must be culturally appropriate and child-oriented. We hope the next generation reaps the benefits of these vision screening guidelines for very young children and children with special needs.

This information reached you with the compliments of Depisteo, designers of medical screening devices for professionals.