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I Had a School Vision Screening; Why Do I Need to Schedule an Eye Exam?

Vision screenings can be a great way for children to be referred for further assessments by an Optometrist or Ophthalmologist. They are not a replacement for an annual eye exam, but what is the difference?


  1. While many local school districts offer annual screenings for children, the criteria for these screenings vary from state to state. Most of these rely on cover testing (blocking one eye, then the other to check alignment) and reading an eye chart. These tests only help rule out a strabismus (lazy eye) and check distance visual acuity. All answers provided are subjective. Imagine 25 kids in line reading the same letters, surely no one is repeating what they heard before. A doctor’s office is a much more controlled environment so the data gathered is more reliable. In the doctor’s examination, retinoscopy is performed to eliminate an inaccurate diagnosis. Retinoscopy is an objective test which allows a practitioner to see the way light is bending in the eye. This allows the Doctor to understand whether the child is near or far sighted no matter how badly a child does or does not want glasses.

  2. The human eye is extremely complex, with many structures not visible without a dilated exam. Many conditions are overlooked in a screening including focusing ability, eye teaming skills, and ocular diseases. Focusing skills are one of the most widely overlooked and potential harmful for a child’s academic achievement. Sometimes these problems exist long before school work gets “too hard” allowing a child to struggle unnecessarily. 

  3. Education provided by your eye doctor can also prevent future health issues. For example, did you know more UV light penetrates a child’s lens than an adult’s. Children under the age of 10 absorb 75% of UV light into their lens. Because of the lens’ initial transparency to UV, as much as 80% of the damage to the retina is done by age 21. Sunglasses are just as important as sunscreen.

  4.  Unfortunately, No follow up is conducted after the screenings are performed. According to the “Making the Grade” report published by Luxottica, “as many as 80 percent of children who fail a vision screening do not receive a follow-up eye exam by an eye doctor as recommended.” With a doctors exam there is going to be at least an annual recall if not a recommendation that the child be seen sooner. Even with electronic medical records there is usually no record from one year to another. As most screenings are done by an outside source records are not kept by the school nurse. Continuity of care can be beneficial to treatment options and outcomes. Think about how much better your family care doctor knows you as opposed to your local pharmacy clinic practitioner.

Vision screenings can help recognize when a child needs further assessment but are no substitute for a dilated eye exam with a vision care professional.

Jessica Harper

Clinic and Contact Lens Coordinator