Vision and eye health: moving into the digital age with instrument-based vision screening

NASN Sch Nurse. 2015 May;30(3):154-60. doi: 10.1177/1942602X15581054.


Significant advancements in vision screening research are leading to improved design, functionality, and reliability of screening tools. Presently, two vision screening approaches are available to school nurses for children ages 3 years and older: optotype-based screening and instrument-based screening. Optotype-based screening pertains to tests of visual acuity using optotypes (e.g., pictures, letters, and numbers), which children identify to determine visual acuity. Instrument-based screening pertains to automated devices that measure amblyogenic risk factors, such as refractive error, media opacities, and eye misalignment. Differences between the two approaches; best and acceptable practice recommendations for both approaches; unacceptable tests of visual acuity; and best, acceptable, and unacceptable occluders are described.

Keywords: HOTV; LEA symbols; Sloan letters; instrument-based screening; occluders; optotype-based screening; preschool vision screening; school-age vision screening.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Amblyopia / diagnosis
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Optometry / methods
  • Refractive Errors / diagnosis
  • School Nursing / organization & administration*
  • Strabismus / diagnosis
  • Vision Disorders / diagnosis*
  • Vision Disorders / nursing
  • Vision Screening / instrumentation*
  • Vision Screening / methods*
  • Vision, Binocular
  • Visual Acuity*