Determining what vision screening to require in schools and the best vision screening instruments

In Washington state, the State Board of Health determines the types of vision screening to require of schools, the grades when students must be tested, and the vision screening instrument schools must use.  Many different factors must be considered when updating early detection requirements. In 2005, the legislature enacted legislation directing that an expert workgroup be formed to reevaluate visual screening of children in public schools and make any recommendations regarding changes to the vision rules to the Board and to report back to the legislature.  In 2011, the Board was asked if school districts could offer vision screening in addition to distance central vision acuity required by rule. The Board created temporary provisions allowing schools to conduct additional vision screening.  Recently, some school nurses have reported problems with the Snellen test chart - indicating that it no longer represents a suitable standard of care.  This point of view was explored by conducting a survey of school nurses in 2014. According to the survey, Snellen letters is the most commonly used method, followed by Illiterate E, House/Apple/Umbrella, Sloan Letters, HOTV Letters, LEA Symbols and a few others. The Board convened an expert vision workgroup to review all of these inputs and suggest ways that the school vision screening requirements might be updated.  At the end of this presentation, participants will be able to list the steps Washington used to answer questions about vision screening requirements in schools and to identify key factors to consider when changing vision screening requirements.