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What is Included in a Strong Vision Health System of Care?

12 Components of a strong children’s vision health system

The NCCVEH at Prevent Blindness has developed a framework for a comprehensive vision screening process. The 12 Components of a Strong Vision Health System of Care begins with providing parents and caregivers with educational material about the importance of good vision for their children now and in the future, as well as scheduling an eye examination when their children do not pass a vision screening. This framework includes information on evidence-based tools and procedures and ends with conducting an annual evaluation.

1. Ensure that all parents/caregivers receive educational material, which respects cultural and literacy needs, about the importance of:

a. good vision for their child now and in the future;

b. scheduling and attending an eye exam when their child does not pass vision screening.

2. Ensure that parent/caregiver’s written approval for vision screening includes permission to:

a. share screening results with the child’s eye doctor and primary care provider;

b. receive eye exam results for your file;

c. talk with the child’s eye doctor for clarification of eye exam results and prescribed treatments;

d. share eye exam results with the child’s primary care provider.

3. Screen vision with age-appropriate and evidence-based tools and procedures, including optotypes (pictures) and/or instruments.

a. Follow national referral and rescreening guidelines.

b. Include vision screening training for your staff that leads to certification in evidence-based vision screening procedures.

c. Ensure that contracted screening organizations use evidence-based tools and procedures, utilize national referral and rescreening guidelines, and clearly state that a screening does not replace an eye exam nor provide a diagnosis.

4. Create policies for screening or direct referral for children with special needs.

5. Rescreen or refer difficult-to-screen (untestable) children.

a. Research suggests that untestable children are twice as likely to have a vision problem than children who pass a vision screening.

b. If you have reason to believe that the child may perform better on another day, consider rescreening the child within 6 months*. Otherwise, refer untestable children for an eye exam.

6. Provide parents/caregivers with vision screening results in easy-to-understand language, which respects cultural and literacy needs and provides steps to take for prompt follow-up with an eye care provider.

a. Provide written and verbal results.

7. Create a system for following-up with parents/caregivers to help ensure that the eye exam occurs.

a. Identify and remove barriers to follow up to eye care, such as transportation or a lack of knowledge of what will occur during the eye exam.

b. Consider ways to engage parents in peer-to-peer conversations to encourage follow up to eye care and adherence to prescribed treatments.

8. Link parents/caregivers for an eye examination with an eye doctor who specializes in the care and treatment of young children.

9. Receive eye exam results for your files.

10. Send a copy of eye exam results to the child’s primary care provider.

11. Ensure that the eye doctor’s treatment plan is followed.

a. Develop a plan

12. Evaluate the effectiveness of your vision health program annually.

a. Compare screening results to eye exam outcomes.

b. Identify variations in referral rates among your screeners.

c. Monitor screening procedures to ensure they follow current recommendations.

d. Monitor follow up to eye care for children who do not pass vision screening or who were untestable.

e. Look for common barriers in follow up to eye care and development and implement solutions.

* (American Academy of Ophthalmology Pediatric Ophthalmology/Strabismus Panel, 2012)