VISION SCREENING
PROGRAM
Cobb County School District 2014-2015
Vision Consultant
 Dr. Ivo Horak
 735 Windy Hill Rd.
Smyrna, GA 30080
 770-436-9123 (office)
 ivohorak@bellsouth.net
 www.youreyesrus.com
MAP to Dr. Horak’s Office – pg. 2
Feel free to copy/share with parents.
Vision Screening Program
 Supervisor
Heidi.Evans@cobbk12.org
 Education program specialists
LeAnn.Barnes@cobbk12.org
Teresa.Vento@cobbk12.org
What to do first?
DISCARD ALL OF YOUR OLD SCREENING
MANUALS AND
USE ONLY THE CURRENT
YEAR’S MANUAL.
DON’T USE THIS EYE
CHART…….
Common Vision Terminology
 20/20
 You can see clearly at 20 ft what should normally be
seen at 20 ft.
 Average Vision – NOT Perfect Vision
 20/100
 You have to be at 20 ft to see clearly what should
normally be seen at 100 ft.
 20/15
 Better than 20/20!
 You can see clearly at 20 ft what should normally be
seen at 15 ft.
Common Vision Problems
Near Sightedness/Myopia
 Objects up close are
clear
 Objects far away are
blurry
Far Sightedness/Hyperopia
 Objects up close are
blurry
 Objects far away are
clear
Common Vision Problems
Astigmatism
 All objects near and far
are distorted
Presbyopia
 The eye can no longer
focus up close
Common Vision Problems
 Amblyopia or Lazy
Eye
 Strabismus or
Crossed Eye
 Vision in one eye is
 One or both eyes turn
weaker than other. The
brain suppresses the
weaker eye and uses the
good eye
 Usually develops before
age 6
 6,7 critical age for foveal
development
 Tx: patching, Sx
in,out, up, or down due to
weak muscle control
 Can develop as late as
age 6
Vision Screening Program
 We are trying to detect students who may have a vision
disorder to refer for further care.
 It is estimated up to 25% of school age children have
undetected, treatable vision problems that can interfere
with learning.
 A child with an undetected or untreated vision problem is
more likely to develop social or emotional problems. Thus,
a child's vision problems can affect not only their own
learning, but that of their peers. Vision screening
empowers organizations to ensure children have the
opportunity to reach their full potential
NOTE:
 If a child has an excessively red eye (or eyes), or
crusting on the eyelashes or eyelids
 DO NOT SCREEN the child. Send home the V1
letter, and mark the child as “fail” for the vision
screening.
 Child needs medical attention.
Digital Eye Strain
Digital devices are putting stress on the visual system
• Back lit LED screens
• Smart phones started 6 years ago
• Tablets are 3 years old
40% of 3rd-12th grade own a tablet
40% of college students use tablets as their main computer
35% of US population own tablet and 60% own a smartphone
Causes children to constantly converge and diverge eyes while
trying to focus on the screen--leads to starring --->decreased blink
rate
Children are using technology at a younger age, and small children
hold things closer to their eyes
Digital Eye Strain- con’t
Symptoms of Digital Eye Strain
-fluctuating vision, decreased concentration
-dry eyes
-red eyes
-burning eyes, fatigue
**Eyes get locked into over-focusing.
Child may be wearing wrong Rx. ie: false myopia
-exam often done after child playing on tablet/phone in
waiting room
Recommend the 20-20-20 rule
High Energy Blue Light
Found in LED bulbs and also emitted from tablets
-Different wavelengths of visible light focus on different parts
of retina
-Blue light stresses the focusing system
Melatonin tells brain that we need to sleep
Blue light suppress Melatonin->decreased sleep->disrupted
circadian rhythms
-->obesity, fluctuating moods-hormonal changes.-->decreased
learning
Recommend to stop using Tablets 1-2 hours before bedtime.
Vision Screening Program
 Who do we screen (for the MASS
screening)?
 Grades 1, 4, 7, & 10
Vision Screening Program
 NOT a substitute for routine vision care.
 NOT a diagnostic procedure; does not
determine whether glasses will be needed.
 Children should see an Optometrist or
Ophthalmologist before K.
 Annual eye exams are recommended for kids
with glasses and/or contacts.
 Children who do not wear corrective eye wear
should also have an eye exam every year.
Vision Screening Program
 All new students need a completed Certificate of
Ear, Eye, and Dental Examination (Form 3300) on
file
 Completing a 3300 form is NOT part of mass
screening program –Parents should provide this
(from the doctor or health department)
 Remember – this is for NEW STUDENTS – only
ONE From 3300 is required to be on file.
Screening Procedures
 Methods: HOTV or Titmus or Lea Symbols
 If student initially fails, retest within 2 weeks
 Fails a 2nd time, parents notified with letter V-1
 Parents can
 Take child for eye exam
 Take child for re-screening with Dr. Horak, Dr. Davison, Dr.
Mobley, or Dr. Schirack at no charge
 PARENTS ARE RESPONSIBLE FOR COSTS OF FULL EXAM
V-1
Form
ABC’s of Detection
Appearance Signs:
Eyes crossed
Droopy lids or Swollen lids
Unequal pupils
Pink eye / watery eyes
Eyes in constant motion
Behavior Signs:
Rigid body while viewing distant
objects
Tilting head
Rubbing eyes
Excessive blinking
Squinting
Complaint Signs:
Eyes burn / itch
Seeing double
Unusual light sensitivity
Headaches
Letters jump together
Screening Procedures
 If a child wears glasses perform the screening with the
glasses on.
 If child fails WITH glasses, the glasses may be for
reading – try screening without glasses.
 Screening Challenges
 Shy or Frightened
 Learning disability
 First Language not English
 Hearing Loss
 Malingering vs Hysteria
Screening Techniques
HOTV and LEA Charts
Titmus Machine
 Screens for distance
 Can screen for both
vision only
 Overlooks
farsightedness
 Efficient
 Less costly
 ONLY DISTANCE IS
distance & near vision
 Can Test muscle
coordination
 Can test color vision
 More time consuming
REQUIRED FOR
MASS SCREENING
Form V2
Page 16
in Manual
Spanish
version on
Page 17
HOTV Testing (Preferred method)
 If you need more charts:
 HOTV charts available at
www.bernell.com or
www.macgill.com or
 www.preventblindness.org
 EACH eye must pass in
order for student to pass
the screening.
FYI
1.
2.
3.
4.
5.
6.
7.
8.
Schedule visual screenings early to maximize learning
potential.
Use index cards as occluders (not hands)
Cut a curved edge on index cards, so as not to poke
students in the eye!
Make sure both eyes are open to prevent squinting
Check each wall chart for proper screening distance.
Be aware of potential letter memorization (Allow only
one student in the screening area at a time)
Create a comfortable environment with adequate
lighting to minimize distraction
Minimize cross-contamination (use a fresh index card
for each student, then discard the card.)
HOTV Testing
 Child points to matching
stimulus card (or simply says the
name of the letter) as adult points to
each letter in the row.
 Place chart at eye level from floor
(eye level depends on the age/height
of the students being screened)
 20/40 line – K & 1st Grade
 20/30 – 2nd thru 12th
 Must identify 3 out of 5 letters to pass
 EACH eye must pass
HOTV Testing
 Fail once, retest 2
weeks
 Fail twice, send V1
 If no response in 30
days from parents, V2
 ALL TESTING IS
CONFIDENTIAL
Letters V1 & V2 (also in Spanish)
V-1
Form
Titmus Testing
 Titmus machines available at
www.schoolhealth.com;
Telemetrics
 1-800-523-8583
 www.macgill.com
 Special Student Services at 678-
581-7400 has some
machines for check out
 Must pass only distance
portion for MASS screening
Titmus Testing
 Prior to testing kids, check your
Titmus manual
 Student should wear glasses
 The 20/40 slide (ex: Boy, Girl,
Bird, Rabbit) is passing for
Grades K – 1 - Must respond
correctly with EACH eye
 The 20/30 slide is passing for
grades 2 – 12. Must respond
correctly with EACH eye
Titmus
Recording
Form
STUDENTS NAME: ___________________________________________
VISION CORRECTION: ___ NONE ___ GLASSES ___CONTACTS
DISTANCE VISION TEST:
LEVER
SETTING
FAR
FAR
Page 11-13
in Manual
PLEASE
CHECK
GRADE
LEVEL AT
TOP OF
PAGE.
DATE: ______________
DIAL
SETTING
/RESPONSE
5
5
INITIAL DATE:____________
RIGHT EYE
SWITCH
LEFT EYE
SWITCH
ON
ON
OFF
OFF
1ST SCREEN
PASS
RESCREEN DATE: _____________
1ST SCREEN
FAIL
FOLLOW
UP PASS
FOLLOW
UP FAIL
INSTRUCTIONS: Firmly position your forehead against the forehead rest. Both eyes open. From left to right which direction does the “E”
symbol point to? Line C (20/30 line)– Left: 3 W W 3 E M Right: 3 M E E 3 W
EXCESSIVE FARSIGHTEDNESS TEST:
LEVER
DIAL
RIGHT EYE
SETTING
SETTING
SWITCH
/RESPONSE
FAR
5
OFF
FAR
5
ON
LEFT EYE
SWITCH
1ST SCREEN
PASS
1ST SCREEN
FAIL
FOLLOW
UP PASS
FOLLOW
UP FAIL
ON
OFF
INSTRUCTIONS: Insert Plus Lens Unit. Firmly position your forehead against the forehead rest. Both eyes open. From left to right,
which symbol does the “E” symbol point to? IF THE STUDENT CORRECTLY IDENTIFIES THE DIRECTION OF 4 OUT OF 6 OF THE
“E’s” THEY WOULD FAIL.
MUSCLE BALANCE TEST:
LEVER
DIAL
SETTING
SETTING
/RESPONSE
FAR
6
NEAR
6
RIGHT EYE
SWITCH
LEFT EYE
SWITCH
ON
ON
OFF  ON
OFF  ON
1ST SCREEN
PASS
1ST SCREEN
FAIL
FOLLOW
UP PASS
FOLLOW
UP FAIL
INSTRUCTIONS: Remove Plus Lens Unit. Firmly position your forehead against the forehead rest. Both eyes open. Do you see a box with
an “A” and a box with a “B” in it? Turn the left eye on and ask the student which box the red ball is in. If the red ball is in box “A” or on the
line between “A” or “B” then the student passes. Any other response the student fails.
COLOR VISION TEST ( E, 3, M, W, M, 3,W, E)
LEVER
SETTING
FAR
DIAL
SETTING
/RESPONSE
7
RIGHT EYE
SWITCH
LEFT EYE
SWITCH
ON
ON
1ST SCREEN
PASS
1ST SCREEN
FAIL
FOLLOW
UP PASS
FOLLOW
UP FAIL
INSTRUCTIONS: Firmly position your forehead against the forehead rest. Both eyes open. Starting with box 1 which direction does the “E”
point? R=right L= left U= up D=down. (5 out of 8 correct responses = a pass)
PLEASE NOTE
 KG/1st Grade Sample Form (page 11)
 Do the first 6 slides
Screening Authorizations
 Parent permission is NOT required for students:
 Grades 1, 4, 7, & 10
 If you feel any other student needs a screening –
form V3 (page 18) needs to be signed by parent or,
in the case of a Special Education referral, the
Special Education 2102 form may be used.
Screening Procedures
 General Education Students
 Can be corrected to 20/30 or better & takes general ed courses
 Use standard screening/authorization procedures
 Special Education Students
 If student has adequate comprehension but is unable to pass – follow
standard screening procedures
 If student does not comprehend – try LEA chart. If still no results do not
retest  send V1 and a copy of Cobb Co. School Eye Report for Children
with Vision problems to parents (Page 24/25 in Manual)
 Visually Impaired students- DO NOT SCREEN STUDENTS
ARLEADY IDENTIFIED / SERVED by VI PROGRAM




Their vision needs are already documented
Vision cannot be corrected better than 20/70
Part of the Visually Impaired Program
Contact Heidi Evans
Eye Exam Resource Guide
 Cobb County School System does NOT pay for eye
examinations….. (though we do provide re-screenings for
students who fail their school screening – at no charge to
families.)
 Medicaid
 PeachCare
 Sight for Students (VSP Vouchers)
 Lions Lighthouse
Total Reporting (page 20)- Due Jan 16, 2015
Schools with Titmus - bring your machines to
check out sessions, please!
Thank you!
(Please take the quiz now)