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Pediatric ophthalmologist designs vision screening kit for schools, physicians


That’s one reason vision screening for children in school settings is so important to Dr. Neely, a professor of ophthalmology in the IU School of Medicine Department of Ophthalmology at the Eugene and Marilyn Glick Eye Institute. He recently designed a vision screening kit for the American Academy of Ophthalmology Leadership Development Program in which he’s participating this year. 

“It’s important to identify eye disorders in children at an early age to avoid lifelong visual impairment,” Dr. Neely said. “Vision screening for children is a low-cost, efficient way to identify children who could be at risk for developing serious visual impairments.”

Children are never too young for a vision screening; even newborns are examined. Schools, pediatricians and family practice physicians use several methods to identify common eye ailments such as amblyopia (lazy eye) or strabismus (crossed eyes or eyes that turn out) and refractive errors such as myopia (nearsightedness) or hyperopia (farsightedness) and astigmatism. Vision screenings also can detect cataracts, glaucoma, ptosis and other serious conditions that require immediate treatment.

Screenings are important because:

  • Vision problems are frequently not noticeable to parents.
  • Many children cannot report a vision problem unless it is sudden, as they are unaware that something is wrong.
  • Pain is often not a side effect of vision problems.
  • Undiagnosed or untreated vision problems can result in vision loss.
  • Early treatment gives children the best opportunity for good eyesight as an adult.

Dr. Neely said he hopes health care workers across the country will take advantage of the new screening kit.

“This vision screening kit was just finished last week and is premiering at the National Association of School Nurses conference, and will be introduced to the Indiana school nurses at their meeting in July,” Dr. Neely said. “There are actually two kits, a basic version and a version that includes the basics plus some supplemental tools. Both are designed to provide the necessary means for school nurses or primary care physicians to perform a quick and accurate pediatric vision screening.”

In Indiana, schools are required to conduct vision screenings to test visual acuity of children in Grades 3 and 8 using the Snellen E chart or Snellen alphabetical chart. The new screening kit contains a Lea symbols chart for use with children who do not know the alphabet and a more traditional Sloan letters chart for children age 5 and older who know their ABCs.

Lea symbols are an apple, house, square and circle and can be identified verbally or by using a card that contains matching symbols. They can be used by preliterate children ages 2 to 5,  nonverbal children or non-English-speaking children, Dr. Neely said. Sloan letters are a variant of traditional Snellen letters, but the font is without serifs. Also, unlike an old-fashioned Snellen eye chart, Sloan charts usually follow a format that includes five letters on each line with consistent spacing between each line.

Detailed instructions on their use are included in the kit, which contains CDs with supporting information for vision screeners, Dr. Neely said. The kit is manufactured by the Good-Lite company.

Children who do not pass a vision screening should be examined by an ophthalmologist for a follow-up eye exam to determine whether the child has a vision problem. Eye doctors can employ a variety of tests and assessments to determine whether a vision problem is present. 

Dr. Neely, who this year is chairman of the vision screening committee for the American Association for Pediatric Ophthalmology and Strabismus, developed the vision screening kit with support and approval from the AAPOS Vision Screening Committee and the AAPOS Board of Directors, as a project for the American Academy of Ophthalmology’s Leadership Development Program. More information about the kit is available on the AAPOS website.