Vision Screening Report Examples
Dept of Education Referral Process
The school nurse is responsible for coordinating and supervising the school vision screening program from beginning to end. Identifying students who may be at risk for vision impairments is just the first step in the school vision screening program. Symptoms related to vision problems can greatly affect a student’s ability to learn. In addition, low‐income minority youth are more likely to experience a disproportionately high prevalence of educationally relevant vision problems. Unfortunately, studies show that a large number of students who need glasses do not have them. For a screening program to be effective, school nurses must place an emphasis on the referral and follow‐up process.
It is recommended that screenings be completed by the end of the first semester. In cases where this is not possible, it is recommended that the same grades be screened at the same time each year.
Re‐screening should be completed by the school nurse or other well‐trained personnel within 30 working days following the initial school vision screening.
All students who fail the re‐screening should be referred to the school nurse for review. The school nurse must use professional judgment while considering each student’s circumstances to determine the appropriate actions to be taken. The following circumstances call for a vision referral:
Evidence that student has not passed the screening
Screening findings are inconclusive
Legitimate concerns of a parent, teacher or student
Observations or behaviors suggesting vision problems, despite passing the school screenings
The initial parent/guardian notification regarding the student’s failed vision screening/vision concerns should occur within 10 days vision screening. The referral form should include the following:
Student’s school screening results
Observations or comments related to vision concerns if available
School nurse signature and contact information
Space for the eye care professional to provide results, recommendations for school and lens prescription information
Clear statement on the document requesting that the referral form be returned to the school nurse
The school nurse should be prepared to answer parents’ questions and concerns related to the vision referral and familiarize themselves with the following:
Explanation of the school vision screening process
Understanding how vision impacts academic progress
Available community resources
Family and cultural influences