Screenings vs Eye Exams

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As a parent, it is important to know the difference...
Many parents are under the impression that the vision screening their child receives from the school nurse or at the pediatrician's office is sufficient. There are no set standards or criteria for passing a vision screening; and a vision screening can give a parent a false sense of security. It is estimated that 15-20% of school-aged children have a vision problem that a vision screening will miss.
The American Optometric Association reports that 5-10% of preschoolers and 25% of school-aged children are diagnosed with vision conditions significant enough to impact learning once they have a comprehensive pediatric vision examination.
Current vision screening methods cannot be relied upon to effectively identify individuals in need of vision care. In some cases, a vision screening may actually serve as an unnecessary barrier to an early diagnosis of vision problems. Vision screenings can create a false sense of security for those individuals who "pass" the screening, but who actually have a vision problem, thereby delaying further examination and treatment.
To understand why vision screenings may not find a vision problem, we need to look at the factors that can limit their effectiveness.

Limited Testing

Many vision screenings test only for distance visual acuity. While the ability to see clearly in the distance is important, it does not give any indication of how well the eyes focus up close, or work together. It also does not give any information about the health of the eyes.
Some screenings may also include a plus lens test for farsightedness and a test of eye coordination. However, even these additional screening tests will fail to detect many vision problems.

Untrained Personnel

Often times a vision screening is conducted by administrative personnel or volunteers who have little training. While well intentioned, these individuals do not have the knowledge to competently assess screening results.

Inadequate Testing Equipment

Even when done in a pediatricians' or primary care physicians' office, the scope of vision screening may be limited by the type of testing equipment available. Factors such as room lighting, testing distances and maintenance of the testing equipment can also affect test results.
According to a study published by the American Academy of Pediatrics, vision screenings were attempted on fewer than 60% of the three-year old children in pediatricians' offices. They found that in general, the younger the child, the less likely it was that a vision screening was attempted. An attempt was defined as 10 or more seconds spent trying to get the child to cooperate with a vision screening.

Further Vision Screening Limitations

The purpose of a vision screening is to diagnose "gross abnormalities" in distance vision. Vision screenings are a limited process and cannot be used to diagnose an eye or vision problem, but rather to indicate a potential need for further evaluation. Additionally, screenings do not typically include any sort of test for near vision; which is the vision used when drawing, coloring, putting puzzles together and in the classroom.

Pediatric Vision Examinations

Just as children should visit the pediatrician and the dentist, they should also see a licensed eye care provider for a Pediatric Vision Examination. A Pediatric Vision Examination differs from a typical eye exam because it includes testing and evaluation of visual skills in addition to visual acuity.
At Artisan Optics, Pediatric Eye Examinations are performed by a Residency Trained Pediatric Optometrist and include the following:
  • Acuity - Distance Vision: visual acuity (sharpness, clearness) at 20 foot distance.
  • Acuity - Near Vision: visual acuity for short distance (specifically, reading distance).
  • Focusing Skills: the ability of the eyes to maintain clear vision at varying distances.
  • Eye Tracking and Fixation Skills: the ability of the eyes to look at and accurately follow an object; this includes the ability to move the eyes across a sheet of paper while reading.
  • Binocular Vision or Fusion: the ability to use both eyes together at the same time.
  • Stereopsis: binocular (two-eyed) depth perception.
  • Convergence and Eye Teaming Skills: the ability of the eyes to aim, move and work as a coordinated team.
  • Color Vision: the ability to differentiate colors.
  • Evaluation of age-appropriate vision skills.
  • Remember, an eye exam that tests distance vision only is not an adequate evaluation of a child's visual development. The visual skills listed above affect a child's success in reading (comprehension and reading rate), overall academic achievement, and sports performance.
Since 1991, our team of trained specialists have been providing accurate, professional diagnosis and state-of-the-art treatment you can count on. Our expertise, experience and results speak for themselves. We look forward to being of service to you and your family.