Current through Register Vol. 49, No. 9, September, 2024
ARKANSAS DIVISION OF ELEMENTARY AND SECONDARY EDUCATION
RULES GOVERNING EYE AND VISION SCREENING REPORT IN ARKANSAS PUBLIC
SCHOOLS
May 2, 2022
1.0
PURPOSE
The purpose of these Rules is to establish the requirements and
procedures for governing eye and vision screening procedures and test standards
in Arkansas Public Schools.
2.0
REGULATORY AUTHORITY
These Rules are enacted pursuant to the authority of the State
Board of Education under Ark. Code Ann. §§ 6-18-1501et seq. and
25-15-201 et seq.
3.0
DEFINITIONS
For the purpose of these rules, the following terms
mean:
3.01 "Commission" means the
Arkansas Commission on Eye and Vision Care of School Age Children, which is
established by the State of Arkansas to study the eye and vision needs of
school age children, evaluate current vision screening programs, and make
recommendations to develop a strategic state wide plan to ensure adequate eye
and vision care for the school age children of Arkansas.
3.02 "Division" means the Arkansas Division
of Elementary and Secondary Education.
3.03 "Screening" means to test in order to
separate according to skills or ability.
3.04 Vision Care Consultant means an
optometrist or ophthalmologist.
4.0
VISION SCREENINGS / APPROVED
INSTRUMENTS
4.01 All students in
pre-kindergarten (PK), kindergarten (K), grades one (1), two (2), four (4), six
(6), and eight (8), and all transfer students shall receive an eye and vision
screening.
4.02 The requirements in
these Rules apply to students attending all public schools and public charter
schools.
4.03 Nothing in these
Rules shall preclude voluntary screening of any educational grade or preclude
the referral of any student, regardless of grade, who the teacher or school
nurse feels should be screened or examined.
4.04 The responsibility for the enforcement
of these Rules rests equally with each school district or charter school and
the parent or guardian of the student.
4.05 The Division and Commission establish in
these Rules the tests, procedures, equipment, and instruments that shall be
used to perform eye and vision screenings.
4.06 The approved screening process will
include the following:
4.06.1 Observation and
external inspection of the eye;
4.06.2 Distance visual acuity test using a
Snellen Eye Chart at twenty feet (20') or an age or developmentally appropriate
chart at ten feet (10') outside a vision-screening instrument;
4.06.3 A plus lens visual acuity test using a
Snellen Eye Chart at twenty feet (20') or an age or developmentally appropriate
chart at ten feet (10') outside a vision screening instrument;
4.06.4 Lateral muscle balance test at
far;
4.06.5 Vertical muscle balance
test at far;
4.06.6 Fusion or
binocularity at far;
4.06.7 Lateral
muscle balance test at near;
4.06.8
Fusion or binocularity at near; and
4.06.9 Color perception.
4.06.10 Screening instruments and equipment
must be approved. These instruments may include, but are not limited to the
following:
4.06.10.1 Titmus Vision
Screener;
4.06.10.2 Keystone Vision
Screener;
4.06.10.3 Optec Vision
Screener;
4.06.10.4 Slides
necessary to perform required test;
4.06.10.5 Occluder;
4.06.10.6 Plus 2.00 lens;
4.06.10.7 Snellen Chart;
4.06.10.8 Age appropriate vision screening
chart;
4.06.10.9 Color perception
booklet/instrument slide;
4.06.10.10 Automated testing instrument (auto
refractor); and
4.06.10.11 Other
approved instruments.
5.0
SCREENING
5.01 The Division and Commission shall set
forth the following criteria for passage or failure of a vision screening and
criteria for referral for a comprehensive eye examination:
5.01.1 External Observation: Any obvious
anomaly of the eyes or periocular areas should cause referral for medical
evaluation. Abnormal head positioning, such as a chronic head tilt, should
result in a failed screen. Obvious misalignment of the eyes should result in a
screen failure.
5.01.2 Vision at 20
feet or 10 for age appropriate charts: Any eye with vision less than or equal
to 20/40 shall result in a screen failure.
5.01.3 +2.00 lens test: Any student that
improves 2 or more lines of vision, such as 20/40 to 20/20 with the +2.00 lens
in front of either eye, shall result in screen failure.
5.01.4 Color Perception Test: This test shall
be performed using an instrument slide or color-testing booklet or color
perception slides. Any student missing more than 25% of the cards or instrument
slide would be deemed a color perception screen failure, but not referred for
comprehensive eye examination. The parent and teacher shall be notified of the
color perception screening failure.
5.01.5 Passing or failing the following
instrument screenings:
5.01.5.1 Lateral Muscle
Balance at far;
5.01.5.2 Vertical
Muscle Balance at far;
5.01.5.3
Fusion at far;
5.01.5.4 Lateral
Muscle Balance at near; and
5.01.5.5 Fusion at near.
5.02 Public schools may utilize an
automated testing instrument to conduct the required vision screening tests for
all students in Pre-Kindergarten through grade twelve (12), subject to the
following:
5.02.1 The instrument must check
distance vision and both lateral and vertical muscle balance;
5.02.2 Other tests required by these Rules
must be completed using the standard screening methods, if possible;
and
5.02.3 Districts that choose to
utilize an automated screening instrument (auto refractor) must use the
following protocol:
5.02.3.1 If a student
fails with use of the automated instrument, the student must be re-screened
with the standard school screening method when possible; and
5.02.3.2 Use of the automated screening
instrument shall be documented in eSchool.
5.03 The Division and Commission shall
develop standards for training school nurses to perform eye and vision
screenings that include, but are not limited to, the criteria set forth in
Section 5.01 and 5.02 of these Rules.
5.04 An eye and vision screening report shall
be sent or given to each parent or guardian of each student in need of a
comprehensive eye and vision examination that has failed a second
vision-screening test.
6.0
EYE EXAMS
6.01 A student who does not pass the eye and
vision screening tests, except for the color perception test, shall be required
to have a comprehensive eye and vision examination conducted by a vision care
consultant within sixty (60) days of receipt of the vision screening report
identifying the need for the examination.
6.02 The parent or guardian of the student
shall be responsible for ensuring that the student receives the appropriate eye
and vision examination.
6.03 The
local school district shall take such action and access all resources necessary
to encourage that the student receives an appropriate examination. If a student
does not receive an appropriate examination, as evidenced by a certificate
signed by a vision care consultant acknowledging the examination, then the
school where the child is registered shall report this to the
Division.
6.04 A student who has
had a comprehensive eye and vision examination conducted by a vision care
consultant within six (6) months of an eye and vision screening is not required
to have another examination if the parent or guardian of the student presents
evidence of a comprehensive eye and vision examination in the form of a
certificate signed by a vision care consultant acknowledging the
examination.
6.05 Transfer students
who have been screened in their previous school during the current school year
do not have to be rescreened at the new school. Schools may request the
transfer student's vision screening from his/her school that was completed
within the current school year.
7.0
FORMS
7.01 The Division, in conjunction with the
Commission, shall develop standardized forms to be used in conducting and
reporting the results of eye and vision screenings.
7.02 The standardized forms shall include:
7.02.1 A vision screening form;
7.02.2 A parent notification form;
7.02.3 A doctor report form;
7.02.4 A form to report the results of
screening and examination; and
7.02.5 Any other forms deemed necessary by
the Division or Commission.
7.03 Every public school shall use the
standardized forms for eye and vision screening reports.
8.0
TRAINING
8.01 The Division, in conjunction with the
Commission, shall develop standards for training school nurses to perform eye
and vision screenings.
9.0
REPORTING
9.01 Each public school shall de-identify eye
and vision screening results as necessary to comply with privacy laws and
report the results by grade to the Division and Commission.
9.02 The report shall include the following
information:
9.02.1 The number of students
screened;
9.02.2 The number of
students re-screened;
9.02.3 The
number of students who did not receive an eye and vision screening;
9.02.4 The number of students referred for a
comprehensive eye examination;
9.02.5 The number of students who failed the
eye and vision screening who did not receive a comprehensive eye examination;
and
9.02.6 The comprehensive eye
examination will be reported as normal or treatment required.
9.03 Eye and vision screening
shall be completed annually and reported to the Division in Cycle 7 reporting
(by June 15th) of each school year.
9.04 Annually, the Commission and Division
shall report its findings and updates to the Governor, the Legislative Council,
and the House and Senate Committees on Public Health, Welfare, and
Labor.
10.0
CONSULTANT
Each school district is encouraged to select one (1) or more
vision care consultants to serve as non-paid eye and vision care consultants to
provide advice and assistance with eye and vision screenings and
examinations.