Nursing services look to fill in vision screening gaps

Plusoptix Blog_School nurse_Vision Screening

Hearing is mandated in Arizona for school kids, but not vision.


I am the nursing supervisor for the Yavapai County Education Service Agency (YCESA) in Prescott, Arizona. As a needs-based organization, YCESA provides a variety of services to any interested local schools. Often, these are schools that cannot afford to hire full time staff. The services including nursing, counseling, physical and occupational therapy. The YCESA supports 28 schools in our rural, far-flung county.

Arizona mandates proof of a hearing test for school entry . No such requirement exists for vision. To emphasize the importance of vision screening, our team decided to write a grant. Grant’s goal was to create a screening program in the Prescott Unified School District. The program would ultilize our Plusoptix autorefractor. The school had been using traditional vision screenings methods, which are difficult for preschoolers to comply with. Even some kindergarteners can struggle with eye charts as well as children with special needs.

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Connecting those in need with important services

Through coordinated community efforts, our program conducts vision screenings for hundreds of kids every year.


The annual Day 4 Hope, which partner’s schools with sponsoring churches, started more than a decade ago. In Sarasota, 38 nonprofit organizations contribute to these back-to-school events to benefit children in need. At the fairs, each child is given a backpack filled with school supplies, including gift certificates for school uniforms and shoes. Additionally, the children receive books and even free haircuts and hair styling. The events are meant for the entire family, where they can get sheriff identification and family portraits taken. Continue reading “Connecting those in need with important services”

Photoscreening played a life-saving role for my daughter Brianna – by Dorie Leitten

Plusoptix Blog_Brianna Leitten

In April of 2013, when my daughter Brianna was 6, she had a vision screening at school conducted by volunteers from Bloomfield Lions Club in our home town in Ontario County, New York. She received a referral for a full eye examination. I was not concerned as back in February, Brianna’s eye exam at the pediatrician’s office was normal. Plus, my oldest daughter wears glasses. I made an appointment with our family optometrist for 2 weeks later. There, we found out that we had an emergency.


It was Saturday, and our doctor was unable to reach a specialist willing to see Bri immediately. Therefore, she advised we go to an emergency room. When I said I knew a surgeon at a local hospital, she replied, “If you have any cards, you need to play them right now.”

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Eye Care Mission Uses Plusoptix Vision Screener to Help More Children

PlusoptixBlog_Jim Carlins Hopeful ways

The Hopeful Ways Nicaragua project provides free eye care services to this impoverished country, using the Plusoptix Vision Screener.

Plusoptix Blog_Jim Carlin


The mission of the all-volunteer members of Hopeful Ways is to offer a variety of health services and educational opportunities to the poor in Nicaragua. Our primary initiative, however, is providing free eye care services to the needy. After Haiti, Nicaragua is the Western Hemisphere’s second poorest country. Many of the people we serve have never been seen by an eye doctor. In fact, a pair of prescription eyeglasses could cost 6 months’ wages.

Our program depends heavily on the Nicaragua Lions Club to help coordinate our missions. They do everything from providing transportation to spreading the word in the community and signing up potential patients. Lions Club International is the largest service organization in the world with 1.4 million members from 46,000 clubs in 250 countries.


The eye care services we provide include vision screening as well as full eye examinations, eye surgeries, and even prosthetic eyes. We distribute prescription and reading eyeglasses, sunglasses, safety glasses, and even eye moisturizing drops.

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Squinting is a risk sign in children

When babies are born they still have to learn how to see. In the beginning, it is often difficult for them to properly coordinate the movement of both eyes and to fix objects. That’s why babies squint sometimes. If strabismus occurs temporarily in the first few months, this is no cause for concern. It is properly the so-called baby squint. But parents should pay attention on how the squint develops – does it occur less or does the child still squint?

different forms of strabismus

Vigilance is required if a child squints at six months of age

It is advisable to go to an ophthalmologist with children, who are still squinting after six months of age – especially if even the parents have a vision disorder or had one in their childhood. In most ophthalmic practices there are vision schools where specially trained ophthalmologists are working. Christa Kampf is such an orthoptist who has been examining children in an ophthalmic practice since the 1970s and treats their vision disorders. She says: “Up to the age of eight months temporary strabismus can still be normal – after that no more.”

Connection between strabismus and ametropia

It may happen that there is a big difference in the refractive power of both eyes (anisometropia) and one eye has a significantly better vision than the other. Christa Kampf explains, that this can also be related to strabismus: “If one eye has no vision, it eventually falls into rest position. That’s why it happens – sometimes at a later age – that a child suddenly starts to squint.” This can also occur with a high hyperopia.

If strabismus remains untreated, amblyopia can occur

If squinting is not treated, amblyopia develops in 90% of the cases. If this amblyopia is not treated in time, it remains for the rest of life. The amblyopia of the eye results in poor vision, which cannot be compensated by glasses. This is the result of not using one eye. The keen-seeing eye is preferred when squinting gives double vision to the brain or when an eye delivers blurred images due to a refractive error. So it can happen that an actually healthy eye is simply switched off. Spatial vision cannot develop properly, for this the child has to learn to have binocular vision.

Preventive eye care offers best treatment opportunities – start with an amblyopia screening at the pediatrician’s office.

“The sooner a vision disorder is treated, the better amblyopia can be treated or even prevented.” Spatial vision can still be learned, because the learning ability is highest in infants and early childhood and most vision disorders are easily correctable.  The prerequisite is that the vision disorder is detected in time, which ideally is in the first two years of life, because visual acuity develops during this time.  A good opportunity for the early detection of vision disorders is the amblyopia screening, which is offered by numerous pediatric practices and reimbursable by many health insurances.  The pediatrician receives objective measurement results, which are compared with the normal values of the age group.  This is possible at the early age of five months.  Children whose measured values differ from the normal values in the age group and whose results are “suspicious” should be referred to an ophthalmologist.


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MEDARVA Vision & Hearing Screening Program – STOP MISLABELING CHILDREN

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Untreated vision problems can lead to kids being called “hyper,” “distracted,” or a “slow learner.”

The goal of MEDARVA Healthcare’s Vision & Hearing Screening program is simply to help as many children as possible. Encompassed in this goal is our driving mission to ensure no one is incorrectly labeled without a full medical investigation. MEDARVA partners with community organizations in the greater Richmond metropolitan area to bring medical assistance to those in need. In advance of the school year, we have launched a social media campaign and are hitting the streets to advance our anti-labeling mission. Continue reading “MEDARVA Vision & Hearing Screening Program – STOP MISLABELING CHILDREN”

Back to school to-do list: About eye health and the role of Plusoptix Vision Screener

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By Jean-Christophe (JC) Firer, Plusoptix CEO


Learning depends on good vision.

As children get ready to head back to school, we reflect on the importance of vision for learning. Colorado Governor John Hickenlooper released a proclamation recognizing the prevalence of undiagnosed and untreated vision disorders. He states that as many as one in four school-age children has vision problems. Vision problems are the most common disorders among children. Coloradoans are reminded to recognize the importance of education in children’s lives. “Parents are encouraged to have their children evaluated for vision problems to maximize their potential in the classroom,” Gov. Hickenlooper said.

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Children’s Eye Health & Safety Month: About objective, device-based vision Screening – by Evan Silverstein, MD

Objective, instrument-based Vision Screening with the Plusoptix Vision Screener

Usually, most children do not need a complete eye examination; however, all children should have serial screenings. Objective, device-based vision screening or photoscreening is an excellent way to accomplish screening in young children. With the right referral criteria in place, screenings in preschoolers can help to identify risk factors for amblyopia. Therefore, children’s screening should be performed yearly.

Recently the American Association for Pediatric Ophthalmology and Strabismus added the option of photoscreening for children ages 12 months to 36 months to its recommendations. If a child fails the screening, it is then referred to an eye care provider for a complete eye examination with dilation.1 Not all children who have a refractive error will need to wear glasses; the treatment will depend on their individual situation and factors such as age and the level of risk for developing amblyopia.

Therefore, it is crucial that there is a follow through when a child  is referred with a “Refer” screening result for a complete exam. Communication is key throughout this process, starting with the person who performs the vision screening.

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Updated Vision Screening Statement Spurs Change in Practice – by Denise Brown, MD

Vision Screening with Plusoptix - Plusoptix Blog - By Denise Brown, MD
In January 2016, the American Academy of Pediatrics updated its vision screening policy for pediatricians. The policy statement recommends that instrument-based screening in the office setting be first attempted between 12 months and 3 years of age and at annual well-child visits thereafter until acuity can be tested directly.
Read how the updated vision screening statement spurs change in a pediatrician’s practice in our today’s blogpost by Denise Brown, MD.

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Early Childhood Photoscreening Supports Better Eye Care in Rural Alaska – By Arwen Botz


Photoscreening is an efficient and effective method of identifying kids at risk for amblyopia.

The Kodiak Area Native Association (KANA) serves a 12,000-member community located on a large, mostly uninhabited island in Alaska. I am a Developmental Specialist with the KANA Infant Learning Program. This is a part of the Alaska Early Intervention system that works with young children, who are experiencing developmental delays, or are at risk of developing such delays, and their families.

KANA collaborates with Alaska Blind Child Discovery (ABCD), a cooperative, charitable research project to conduct vision screening on every preschooler in Alaska. ABCD is the brain child of pediatric ophthalmologist Robert Arnold, MD. During his pediatric fellowship at Indiana University, Dr. Arnold became intrigued with detecting small-angle strabismus using the Brückner Test. After starting practice in Anchorage with Ophthalmic Associates in 1989, he began publishing clinical research around modifying the test. As his interest in photoscreening advanced, Dr. Arnold began working with public health nurses, and later various charities to launch screening clinics in urban and remote villages.

Plusoptix Blog - Early Childhood Photoscreening Supports Better Eye Care in Rural Alaska - Bob Arnold
Pediatric ophthalmologist Robert Arnold, MD

Originally, after photoscreening was conducted at the KANA-run vision clinics, Dr. Arnold had to review all the printouts to determine which kids needed a follow-up exam. For 15 years, this was a tedious and time-consuming process, with often poor picture quality complicating the situation. Then 3 years ago, KANA acquired grant funding to purchase a Plusoptix vision screener. Continue reading “Early Childhood Photoscreening Supports Better Eye Care in Rural Alaska – By Arwen Botz”