Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 173 - CONTROL OF COMMUNICABLE DISEASE
Chapter 7 - SCHOOL HEALTH SCREENING, PHYSICAL EXAMINATION AND VISUAL EVALUATION
Attachment 173-7-2D - HYPEROPIA (NEAR VISION) SCREENING COMPETENCIES

COMPETENCY

KEY POINTS AND PRECAUTIONS

1. Assemble required equipment and supplies.

In addition to eye chart and accurate floor distance measurement, as required for distant vision screening, this screening also requires the use of + 2.50 diopter lenses, suitable for the student holding in front of their eyes to view the vision chart.

Hyperopia screening can be conducted smoothly and efficiently as a final step in distant vision assessment, taking very little additional time and preparation.

2. After the child completes distant vision screening, instruct him or her to remain in place, heels on the line of measurement from the chart, and briefly close and rest the eyes.

The child is instructed (or provided demonstration) of holding up the diopter lenses in front of the eyes as one would hold opera glasses.

Correct recognition of more than half the letters, pictures or symbols on the 20/30 line, viewed through the diopter lenses, constitutes a "non-passing" result.

Screening under poor lighting will affect screening results.

Monocular testing for distant vision may fatigue the eyes, so many students benefit from briefly closing both eyes.

Some nurses find it helpful, on noticing that a child is struggling or straining to read letters on the chart, to simply ask the question: "Are the letters clear or are they blurry?" (Students who pass the test often comment that the letters are blurry.)

If the student wears glasses, the glasses remain on for near vision screening and the diopter lenses are held in front of the student's own glasses.

The inability to read the 20/30 line is considered passing and the child likely has no treatable hyperopia.

3. Record results

A child who can successfully read through the diopter lenses does NOT pass the screening.

Rescreening should be conducted in 2-4 weeks to verify results prior to referral.

4. Carry out rescreen and notification procedures per local school practice/policy

Parents should be notified of need for further evaluation by a vision professional if rescreening results in non-passing outcome.