A Comprehensive Review of State Vision Screening Mandates for Schoolchildren in the United States

Optom Vis Sci. 2021 May 1;98(5):490-499. doi: 10.1097/OPX.0000000000001686.


Significance: Methods and frequency of vision screenings for school-aged children vary widely by state, and there has been no recent comparative analysis of state requirements. This analysis underscores the need for developing evidence-based criteria for vision screening in school-aged children across the United States.

Purpose: The purpose of this study was to conduct an updated comprehensive analysis of vision screening requirements for school-aged children in the United States.

Methods: State laws pertaining to school-aged vision screening were obtained for each state. Additional information was obtained from each state's Department of Health and Education, through their websites or departmental representatives. A descriptive analysis was performed for states with data available.

Results: Forty-one states require vision screening for school-aged children to be conducted directly in schools or in the community. Screening is more commonly required in elementary school (n = 41) than in middle (n = 30) or high school (n = 19). Distance acuity is the most commonly required test (n = 41), followed by color vision (n = 11) and near vision (n = 10). Six states require a vision screening annually or every 2 years.

Conclusions: Although most states require vision screening for some school-aged children, there is marked variation in screening methods and criteria, where the screening occurs, and grade levels that are screened. This lack of standardization and wide variation in state regulations point to a need for the development of evidence-based criteria for vision screening programs for school-aged children.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Delivery of Health Care
  • Educational Status
  • Female
  • Health Care Surveys
  • Humans
  • Male
  • Schools
  • State Health Plans / legislation & jurisprudence
  • State Health Plans / standards*
  • United States
  • Vision Disorders / diagnosis*
  • Vision Screening / legislation & jurisprudence
  • Vision Screening / standards*