Vision issues

Most school nurses do not have enough time to screen the vision of all students enrolled. If they do screen the students they may place too much emphasis on the Snellen chart which evaluates vision at 20 feet. A stereopsis test determines the child’s depth perception at near distances. If the school uses the Snellen Chart plus the stereopsis test, the school can find the majority of vision problems. However, some children with convergence problems (their eyes do not routinely focus on close objects) may be able to over stress their focusing system and pass a stereopsis test. These children will have difficulty reading for an extended period of time. These children need vision therapy rather than corrective lenses. NMLCRF uses the Visagraph to check for eye teaming and eye movement problems. However, students who use Lexia for 20 hours usually remediate eye teaming and eye movement problems.

The Orinda study was a 1965 survey of optometrists and ophthalmologists to determine their standards for prescribing corrective lenses. It had no scientific basis but simply reported on the average standards of this group. Some optometrists rely on the results of the Orinda Study to determine if a child needs corrective lenses. Further, Medicaid incorporates the Orinda study results into their reimbursement standards. That is, if the prescription is not as great as the minimum correction from the Orinda study, Medicaid will not pay for glasses or for the exam. NMLCRF recommends the Wick Standards. Click this link for a further discussion of Vision and Success.

A paper by Roger Johnson and others in the Journal of Behavioral Optometry reported that 97% of the students with behavioral issues failed at least one vision screening test.