1. Dr. Vicky Fischer O.D. - Pediatric Optometrist
Vision Screening Training
Dr. Vicky Fischer O.D. - Pediatric Optometrist

2. Presented by Dr. Vicky Fischer Pediatric Optometrist at Laria Eye Care
and
Heiken Children’s Vision Program

3. Goals of Vision Screening Training
Standardize the Vision Screening Methods
Discuss pros and cons of different eye charts available and test distances
Review and correct common mistakes
Cover the words and phrases we should use with students to achieve best results

4. What is a vision screening?
Measures your distance visual acuity in your right and left eyes
Vision Screenings are done in school, pediatrician’s offices or the DMV
Can miss MANY vision problems

5. Use only the term “Vision Screening”
Do NOT refer to a vision screening as
A vision exam
A vision test
An eye exam
An eye check, etc
Using other terms creates confusion

6. Old Form
New Form since 2011

8. Bad Eye Charts For k & 1st GRADE *The 20/40 Is missing!
*What are these shapes?!

9. Prevents memorization:
Good Eye Charts
For K & 1st grade
Prevents memorization:
left eye right eye
5 symbols
per line

10. Better
Bad

11. Vision Screening in 3 easy steps
Set-up the chart and tape
Stand on the tape & cover the Eye
Record the last line the child could read the majority of the letters
(ie: 3 of the 5)

12. 1. Set-up the chart Place chart at student’s eye level
Mark a line on the floor at the distance the chart is calibrated for

13. What distance is my chart calibrated for?
(This is written on the chart. Newer charts are for 10 ft)
at a 10ft distance the 20/200 letter is 1.75 inches tall
at a 20ft distance the 20/200 letter is 3.5 inches tall E
3.5”↕ E
1.75”↕
20ft↔
10ft↔
My eye chart says to screen at 10 feet, but why does it have
20/XX numbers on the side?
We are accustomed to describing visual acuity in 20 ft notations: 20/20, 20/32, 20/40 etc. Thus: 10/10 on a 10 ft chart is described as 20/20
10/16 on a 10 ft chart is described as 20/32
10/20 on a 10 ft chart is described as 20/40

14. 2. Stand on the line & Cover the left eye
Tell the student to:
“Stand on the middle of the line”
“Cover your left eye with the center (palm) of your hand”

15. What the student does:
What the screener says:
Cover your eye with the palm of your hand

16. What the student does:
What the screener says:
Open your eyes really wide. Can you see them with your eyes open?
Stand up straight like a statue

17. What phrases to use - you’re a cheerleader
What the student says:
I can’t see anything
It’s blurry
It’s too small
uuuhhh
(Kindergarteners won’t say anything)
What the screener says:
Just try your best.
Tell me what you think it is – Wonderful!
Give me your best guess
You are doing great!
Can you point to the one that’s the same? Good job! High Five!

18. How do I get pre-K & K to respond?
Give them the practice card and say:
“Let’s practice! This is a circle, moon, star, heart, triangle”
“Can you touch the circle, moon, star, heart, triangle”
(Pointing to top line of eye chart) “What is this one?” or “Touch the same one”
Once they understand THEN cover their eye

19. How to cover a pre-k eye
They can cover their eye with their palm & you put your hand on top
You can use a clean tissue that YOU over their eye with your palm
You can use an eye patch with a tissue underneath or occluding glasses that you alcohol before use (warning lice risk)

20. Ask the student to read the top line
Then proceed down the right side of the chart reading each line
Stop when the student misses the majority of the symbols on the line
Record the last line that the student can read the majority of the symbols on the line 1 2 3

21. Point with your finger, a pointer, pen cap or pick-up stick
Do NOT use a
Pen tip, pencil or anything that may mark the chart

22. 2. Record the last line majority of letters were read correctly
Cover Left Eye
Cover Right Eye
Record right eye acuity
Pass= 20/30
Record left eye acuity
Refer=20/40

23. Do NOT do “Critical Line” Testing!
Critical Line testing is when you ask the student to start reading at the 20/30 line to speed things up
Critical Line testing causes students to fail UN-necessarily because they get nervous or need time to warm up

24. 1 2 3 Threshold Screening (the fast version)
Example: student 1 right eye
The screener begins at the top of the chart,
1)asks the student to identify the first letter on each line until the student misses the letter
2)Then moves up one line and asks child/student to identify the full line of letter beginning with the 2nd letter on that line
3)Continue moving up one line until child correctly identifies the majority of letters on that line
Cover Left Eye 1 2 3
Refer=20/40

25. 1 2 3 Threshold Screening (the fast version)
Example: student 1 left eye
The screener begins at the top of the chart,
1)asks the student to identify the first letter on each line until the student misses the letter
Continue moving up one line until child correctly identifies the majority of letters on that line
Cover Right Eye 1 2 3
Pass=20/30

26. 1 2 3 Threshold Screening (the fast version)
Example: student 2 right eye
The screener begins at the top of the chart,
1)asks the student to identify the first letter on each line until the student misses the letter
2)Then moves up one line and asks child/student to identify the full line of letter beginning with the 2nd letter on that line
3)Continue moving up one line until child correctly identifies the majority of letters on that line
Cover Left Eye 1 2 3
Pass=20/25

27. 1 2 3 Threshold Screening (the fast version)
Example: student 1 right eye
The screener begins at the top of the chart,
1)asks the student to identify the first letter on each line until the student misses the letter
Continue moving up one line until child correctly identifies the majority of letters on that line
Cover Right Eye 1 2 3
Refer=20/40

28. New Form since 2011
Can you save time by printing the school, date, your name and photocopying?