Guidelines for Vision Screening in Missouri Schools

Infection Control Considerations for Vision Screenings

Vision screeners and school nurses are responsible for complying with applicable Federal, state, and local laws, regulations, ordinances, executive orders, school board policies, and any other applicable sources of authority, including any applicable standards of practice.

Information for School Nurses and Other Healthcare Personnel Working in Schools and Child Care Settings (CDC)

Pediatric Vision Screening Guidance during the COVID-19 Pandemic by the American Association for Pediatric Ophthalmology and Strabismus Vision Screening Committee

Prioritize Screenings

Identify those screenings required or strongly recommended and do not do “extra” screenings. (i.e. 4th grade vision screening could be eliminated as a precaution)
Eliminate screenings that are not socially distanced or extend the duration of student screenings (stereoacuity and near acuity screenings).
Consider requesting documentation of comprehensive eye exam within the last 12 months. Any child with this documentation could be exempted from the schoolscreening.

Location of Screenings

Screening space should be well ventilated according to CDC standards.
Screenings should not occur in areas where students and staff are evaluated for illness.
Vision screenings could be done in classrooms to keep movement down in the hallways. Utilize an empty wall space for the wall chart. Students not being screened should keep their backs to the screening area to prevent memorization of wall chart.
Distance acuity screenings could be held outdoors. Consider the sunlight, shadows, heat and possible wind when planning. Outdoor screenings may need to be moved indoors last minute due to weather.
If having more than one screening station, ensure that stations are at least 6 feet apart to allow for social distancing.
Location should have an entrance door and a separate exit door. If this isn’t possible, extra time in the schedule needs to be allowed to keep individuals from passing simultaneously through the same door.

Screening Personnel

Consider limiting screening personnel to three adults:
- Screener
- Facility employee to clean chairs and monitor distancing, and
- Staff to accompany children traveling to and from classroom and monitor handwashing before and after screening
Limit personnel screening students to those already in contact with the students. The use of outside volunteers/staff should be carefully considered for infection control purposes. If volunteers are necessary, physical distancing should be maintained and face masks worn. Include reminders about infection control practices in the event orientation.

Screening Schedule

Students should stand at least 3 feet apart while waiting outside the screening room. Mark floors where children should stand.
Maintain cohorts when scheduling screenings. Consider grouping and cohorts where students have consistent exposures and plan screening schedule accordingly (i.e. screen the 7th grade science class).
Do not call the entire class to the screening area and limit the number of children waiting - based on the amount of space available for waiting.
If possible, screen students one at a time to ensure physical distancing space.
If pods or cohorts are used (AAP, 2020; CDC, 2020), clean and disinfect the screening area before students from another cohort or pod arrive.

Equipment Needed

Vision screening equipment
Disinfecting Spray/Wipes
Hand Sanitizer or access to hand washing facilities
Tissues
No touch trash cans
Face Masks

General Infection Control Practices

Do not screen students displaying any signs of illness.
Follow guidelines for physical distancing as much as possible. Masks should be worn when not able to maintain physical distancing.
Students and screeners will practice good hand hygiene before and after screening session.
Mark floors to provide a visual guide for maintaining 6-foot distancing between the screener, the child, and between adults.
Conduct a simulated dry run of the traffic flow, timing, spacing needs, supplies, and screening procedures with adults who are informed of, and participating in, safety procedures.
Have disposable occluders and matching cards for younger students so that items do not have be shared.
Clean/Disinfect any possibly touched surfaces between cohorts/groups. This may include tables, occluders, doorknobs, etc.
Disinfect vision acuity chart between each screening session for the protection of the screener.
Do not have mass screening days that include multiple different screening types. This increases congestion in the hallways and waiting at screening stations.

Other helpful tips

Communicate tentative schedule with teachers/staff so classroom plans can be adjusted as needed.
If possible, eliminate screening forms that students carry with them. Consider using a single form that lists students’ names with an area to enter screening results. The screener can maintain this list and give to school nurse when complete.
Take notes immediately after screening about what worked and what didn’t work so future improvements can be made. Also note how long a classtook to screen.

Resources for recommended product for disinfection and cleaning: https://www.epa.gov/coronavirus/about-list-n-disinfectants-coronavirus-covid-19-0

Guidelines for Vision Screening in Missouri Schools

Infection Control Considerations for Vision Screenings

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