Tuesday, January 2, 2024
According to Prevent Blindness Wisconsin, 1 in 17 preschoolers and 1 in 4 school-aged children have a vision problem. However, Wisconsin is one of nine states that does not require vision screenings for preschool or school-aged children. Wisconsin statute, however, does require children entering kindergarten be provided with the Kindergarten Eye Exam form, along with the recommendation to seek out a formal eye exam with a due date of December 31 of that school year.
Test early, test often
Valerie Hon, district nurse and safety committee chairperson at the Portage Community School District, underscores the importance of testing: “Children's learning is largely impacted by their vision. High quality, evidence-based school vision screening, referral and follow up programs are critical for Wisconsin children. Although vision screening is not mandated in Wisconsin, this population screening can identify students with a vision concern.”
“One year, I referred half of the children in a preschool class who did not pass vision screening. The children each had a story for me when I returned to check in. Several received glasses and saw things in detail they had never seen before. Another learned of a pediatric cataract that was scheduled for removal. Children do not know what they are missing until they can see clearly.”
–Valerie Hon
Children often don’t self-report their vision issues. Many children think the way they see the world is how everyone else sees it, too. According to Prevent Blindness Wisconsin, “Critical growth period for a child’s eyes is between the ages of 3-5 years old. During this period, the eyes can grow and change rapidly as they connect and communicate with the brain. PBW recommends for these age groups to be vision screened annually. If vision concerns are not detected early in this age range, a child could suffer from permanent vision loss.”
Hon advocates that specialized school personnel, such as a school nurse, address a vision concern with the family through a referral for an exam by an eye doctor (ophthalmologist or optometrist). Eye specialists evaluate visual acuity and eye health, prescribing corrective lenses, treatments, or other therapies, as necessary. Families are collaborative partners throughout the process.
More vision screeners need to be trained and deployed
Some school districts do support vision screening, often leaning on resources from groups such as the National Association of School Nurses and Prevent Blindness Wisconsin, as well as community partners like the Lions Club.
Prevent Blindness Wisconsin offers a Certified Children’s Vision Screener Training for school nurses and others through the Children’s Vision Health Program. This program trains school nurses, child care center staff, community volunteers, university students, HOSA/high school students and Wisconsin Lions clubs as Certified Children’s Vision Screeners.
The involvement of High School/HOSA students in Vision Screener Training is a new development. Local high schools/HOSA clubs are recruited to assist school nurses with vision screenings in their local feeder schools. This partnership trains and certifies interested high school students as Certified Children’s Vision Screeners and alleviates reduced capacity from school nurses to vision screen elementary school students in their school district. This hands-on approach helps students explore a possible healthcare profession or setting for their future careers. Prevent Blindness Wisconsin is looking to continue growing the High School/HOSA partnership. If you are interested in your class or students becoming certified to help feeder schools in your district/community, contact Prevent Blindness Wisconsin.
Families need access and resources
Families have a lot of daily challenges to balance. A vision referral adds “one more thing” to their plate. Although getting a student’s vision issues addressed may be a high priority to schools because of their impact on academic performance, it may not be the priority that gets a caretaker’s attention.
After a child has been identified as needing follow up from an in-school vision assessment, Hon has school nurses send a referral letter. The referral letter includes an exam outcome form, as well as a list of the local community eye clinics (address, phone number, and some tidbits about whether the site accepts Medicaid or not). It’s important to remember that school families may not otherwise have lived experience to draw from to know about eye clinics. Many people with Medicaid and BadgerCare are unaware of the annual vision exam and glasses benefit
The National Association of School Nurses member benefit can also supply nurses with free eye exam certificates that will pay for a pair of glasses when indicated. Prevent Blindness Wisconsin offers several programs, one offers eligible children a free second pair of glasses, which is important if they forget to wear them to school or have challenges with breakage. Local Lions Clubs may also offer financial assistance as their resources allow and all other options have been exhausted.
Awareness is key
According to Prevent Blindness Wisconsin, As educators are heavily present in a child’s life, they can have a front view to potential vision problems for a child.” Here’s what they want you to keep in mind:
- Recognize the signs and symptoms of a possible vision problem in a child, including how the child’s eyes look on a regular basis, how they behave inside and outside the classroom, and if they mention any complaints about not seeing clearly or struggling to see.
- Ensure your students/school are receiving annual vision screenings for the recommended ages/grades.
- Familiarize yourself with the steps and resources to ensure referred children are accessing vision care.
- Communication is key! Follow up with caregivers to determine if the child has been able to get vision care.
- Reinforce the importance of glasses and wearing them.
- Teach students about Vision and Eye Health. Prevent Blindness Wisconsin has a curriculum which is free for educators and follows the Common Core English Standards. For more information, email Courtney at PBW.
- Remind students to take breaks from screens and get outside! Sunlight helps a child’s eyes grow and develop properly over time. Additionally, being outdoors encourages children to use their distant eye muscles more. Myopia (nearsightedness) is irreversible and can worsen if children don’t have access to regular vision care.
DPI Vision Resources
The DPI has a curated library of resources to help you guide students, parents, and educators. Please reach out to Wisconsin Department of Public Instruction School Nursing and Health Services Consultant Louise Wilson for more information. Many thanks to her for her time, expertise, and guidance with this article.
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