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Public Health Column for the Times-News

Spot-on partnership for student vision screening

Published: Wednesday, February 4, 2015

Health Department columnist

Children don’t typically complain about problems with their vision; they may think that the way they see is the way everyone sees.

Frequent eye rubbing or blinking, a short attention span, avoiding reading and headaches are some signs that may indicate a vision problem, but many times a problem can’t be detected by simply looking at a child.

But each day that eye problems go undetected and untreated, a child’s vision may deteriorate further, leading to vision loss, learning difficulties or delayed sensory, motor and cognitive or social-emotional development. The earlier that vision issues are detected, the more easily they can be treated.

In Henderson County Public Schools, students in first, third, fifth and seventh grades are screened for vision problems by school nurses. Screenings are also done for any student reporting a vision concern or for a student whose parent or teacher has reported a concern.

Traditionally the Snellen chart has been used to screen vision. Most of us are familiar with the chart, if not the name — visually it typically displays a large “E” at the top with 10 additional rows of capital letters that get progressively smaller.

Unfortunately, this method has limitations. While it can be used to identify near and far vision, other conditions such as astigmatism, unequal pupils or unequal refractive air (meaning one eye is far-sighted and one near-sighted) cannot be determined. In addition, it’s difficult to use it for non-verbal students, students learning the English language and students who cannot read letters.

Vision screening is also time-intensive, requiring the joint efforts of a “Vision Team” comprised of school nurses as well as health occupational students from all the high schools, parent volunteers and school staff who have been trained by Prevent Blindness NC.

This year’s screening, however, proved to be a different experience for all thanks to the generosity of the Etowah Lions Club and a new device for vision screening. The club had purchased a Spot Vision Screening Camera, which is essentially a wireless, handheld, screen-anywhere device.

Similar to a point-and-shoot camera, it can capture results for six tests for anyone between the ages of 6 months and 100 years old. The total time to screen is less than one minute — usually about 10 seconds.

This specialized camera is not cheap, but with fundraising, grant money and donations from other Lions Clubs and businesses, the Etowah Lions Club was able to purchase the camera for $7,100. At present, this is the only Lions Club in Henderson County with a Spot Vision Screening Camera.

Ken Wise, first vice president of the Etowah Lions Club, had demonstrated the camera to School Nurse Director Kim Berry, who approved it for use in this year’s screening. Wise, along with Jerry Marsh, Allison Early, Paul Vaughn and Will Hicks, teamed up with school nurses to screen 3,137 students in 17 schools.

Of those students, 410 students were referred for a complete eye examination. The time saved because of the Spot camera and the Lion volunteers was notable and appreciated.

“With the cameras, our screening process ran more efficiently than in years past. Minimal classroom instruction was lost,” said Andi Marshall, a teacher at Dana Elementary. “An entire class could be completed in less than 10 minutes compared to 20 minutes in past years.”

During screening, students sit about three feet from the Spot camera and focus on blinking red, amber and blue lights. The device captures an image of their eyes, but the child feels nothing. The accuracy and quickness of the screening also makes it easier to screen students who may not speak or be able to read yet.

The software in the camera analyzes the light reflected from each retina, and can immediately determine refractive errors (nearsightedness, farsightedness, unequal power), astigmatism (irregular shape of the cornea, eye or curvature of the lens), amblyopic (lazy eye), strabismus (eye misalignment), unequal refractive power (anisometropia) and unequal pupil size (anisocoria).

Results are instant and followed by a printed report indicating whether all the student’s measurements are in range or a complete eye exam with an ophthalmologist or optometrist is recommended. The report is easy to read and includes a photo of the child’s eyes.

School nurses say that follow-through has improved from parents who receive a referral letter and report from the Spot camera recommending an eye exam. For families who may have difficulty paying these costs, school nurses can connect them with multiple resources in our community. The Lion’s Club also helps many Henderson County students pay for eye exams and glasses as well as helping to replace broken or missing glasses for students.

The enthusiasm from school nurses and teachers about the involvement of the Lions and the effectiveness of the Spot camera has been tremendous with praise for the club and their generosity in equipment, time and volunteers. Although the screening does not replace a comprehensive eye examination and can’t detect all diseases and conditions, it’s a huge improvement over the traditional vision screening.

“The school nurses would like to thank the Lions Club for all they have done to benefit our students in Henderson County Public Schools and what they do for the entire community,” said Michelle Lee, school nurse for the Department of Public Health. “We look forward to continuing our partnership for the benefit of our students. To be able to pick up vision conditions that would have been missed in a traditional screening is wonderful.”

Wise also looks forward to continuing the partnership. “The Lions are looking forward to using the Spot camera next year and into the future to provide screening for the schools. We would also like to screen preschool children and other groups.”

Vision has always been a priority for the Lions Club ever since Helen Keller challenged Lions to become “knights of the blind” at their International Convention in 1925. Now technology has brought a new tool to their mission, and Henderson County’s children will benefit from this partnership.

Kimberly Horton is the communications manager at the Henderson County Department of Public Health. She can be reached at khorton@hendersoncountync.org.

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