Passed the School Vision Screening? Why Your Child Still Needs an Eye Exam

Short answer: A school vision screening is a quick check, usually just reading letters on a chart across the room. It is a useful safety net, but it is not an eye exam. Many children who pass a screening still have farsightedness, astigmatism, eye-teaming trouble or an eye health problem that only a comprehensive eye exam will find. If your child is starting school in Georgia, struggles with reading or homework, or has not seen an eye doctor in the past year, book a full exam. At Reimbold Eye Group in Alpharetta we can also complete the vision section of Georgia Form 3300 at the same visit.

What a school vision screening checks

Most screenings in schools, pediatric offices and health fairs take only a minute or two. A nurse, volunteer or staff member asks your child to cover one eye and read letters or shapes on a distance chart. Some programs add a photo screener that takes a quick picture of the eyes. The goal is to sort out which children clearly need to see an eye doctor. A screening is good at catching blurry distance vision, which is the most common sign of nearsightedness (myopia).

Georgia requires a vision screening, along with hearing, dental and nutrition screenings, for every child entering a Georgia public school for the first time. Those results go on Form 3300, the Certificate of Vision, Hearing, Dental and Nutrition Screening, and the screenings must be done within one year before your child starts. A Georgia licensed optometrist is one of the providers allowed to complete the vision part, so many Alpharetta, Milton and Johns Creek families take care of it at their child's eye exam.

What a screening can miss

Passing a screening only tells you that your child could read a certain line of letters that day. (Our guide to what 20/20 vision means explains what chart scores such as 20/30 or 20/40 actually say.) It does not tell you how hard their eyes worked to do it, or whether the eyes are healthy. Here is what commonly slips through:

• Farsightedness (hyperopia). Young eyes can focus strongly enough to see a distance chart clearly, but that extra effort makes reading tiring. A farsighted child may pass the screening and still avoid books, rub their eyes or get headaches after homework.
• Astigmatism. Mild to moderate astigmatism can blur and distort small print at every distance. Our post on correcting astigmatism without surgery explains the options.
• Unequal eyes and lazy eye (amblyopia). When one eye sees well, a child can pass using that eye and never notice the other is blurry. Amblyopia responds best when it is treated early, ideally before about age 8. Our guide to lazy eye (amblyopia) in kids explains the signs and how treatment works.
• Eye-teaming and focusing problems. Convergence and focusing problems make words seem to swim or double after a few minutes of reading. A distance chart does not test them at all.
• Eye health. A screening does not look inside the eye. Only an eye doctor checks the optic nerve, retina, lens and eye pressure.

What happens at a comprehensive eye exam for kids

A full exam with an optometrist takes longer and looks at much more. At Reimbold Eye Group we adjust every step to your child's age and comfort, so toddlers who do not know letters yet can be examined using pictures and light reflexes. A typical visit includes:

• A short health and development history, including how school is going and whether anyone in the family wears strong glasses.
• Vision at distance and up close, for each eye on its own and both together.
• Eye alignment, depth perception, color vision and how well the eyes move and team.
• An exact measurement of the prescription. Dilating drops are often used to relax focusing so hidden farsightedness shows up.
• A careful look at the front and back of the eye using the instruments on our eye care technology page.

You can read more about our children's visits on the pediatric eye exams page, and our guide to how often to get an eye exam covers adults, too.

Signs your child should be seen, even after passing

Book an exam if you notice any of these at home, whatever the screening said:

• Holding books or tablets very close, or losing their place while reading
• Squinting, tilting the head or covering one eye
• Headaches or tired eyes after school or homework
• Avoiding reading, or homework taking far longer than it should
• An eye that turns in or out, or a white or cloudy look in the pupil in photos
• Sitting close to the TV or saying the board at school is blurry

A white or cloudy pupil, or a new eye turn, should be checked promptly rather than waiting for a routine visit.

Why yearly exams matter more than ever

Children's eyes change fast, and nearsightedness is starting younger than it did a generation ago. More time on near work and less time outdoors both play a part. Myopia usually gets worse each school year as the eye grows longer, and a longer eye carries more risk of eye disease later in life. Finding it early opens the door to treatments that slow it down, such as myopia-control contact lenses, overnight DreamSculpt Ortho-K and low-dose atropine drops. Learn more on our myopia management page, see the lenses and visits included in our Myopia Management Program, or compare two popular lenses in NaturalVue vs. MiSight.

The American Optometric Association recommends an eye exam in a child's first year, at least once between ages 3 and 5, and every year once school begins. Yearly visits let us track changes before they show up as falling grades or frustration with reading.

If your child needs glasses

Kids wear glasses they like. Our opticians help children pick frames that fit well, stay put during recess and suit their face, and we use durable, impact-resistant lenses for active kids. If you want a head start, our face shape glasses guide shows which frame shapes flatter round, oval, square and heart-shaped faces, and the same ideas work for children.

Frequently asked questions

Does my child need an eye exam if they passed the school vision screening?

Usually, yes. A screening mostly checks how well a child reads letters across the room. It can miss farsightedness, some astigmatism, eye-teaming and focusing problems, and eye health issues. A comprehensive eye exam checks all of those.

Can an optometrist fill out Georgia Form 3300?

Yes. Georgia allows a licensed optometrist to complete the vision screening part of Form 3300. Bring the form to your child's eye exam and we will fill in the vision section.

How often should kids have an eye exam?

Once in the first year of life, at least once between ages 3 and 5, and then every year once school starts, through high school. Kids with glasses, myopia control or a family history of eye problems may need visits more often.

Will my child have to read letters at the exam?

No. We use pictures, shapes and light reflexes for children who do not know their letters yet, so even toddlers and kids who are shy or nonverbal can be examined.

Are dilating drops necessary for kids?

Often, yes. Children can focus so hard that they hide farsightedness. Drops relax that focusing so we can measure the true prescription and see the back of the eye clearly.

Book your child's eye exam in Alpharetta

Whether you need Form 3300 signed for kindergarten or your child passed a screening but still struggles with reading, we are happy to help. Homeschooling? See our post on eye exams for homeschooled kids. Book online or call 770-776-9000. Reimbold Eye Group is at 4180 Old Milton Pkwy 1-D, Alpharetta, GA 30005, open Tuesday to Thursday 10 am to 6 pm, Friday 9 am to 5 pm and Saturday 9 am to 2 pm.