Vision Screening Online Training Program - Plus Lens Screening

Vision Screening Online Training Program

Module 7: Plus Lens Screening

Children who are 5 years of age and older, who do not wear glasses, and who have passed the monocular visual acuity screening should receive plus lens screening. This procedure is meant to identify children who have passing distance visual acuity (myopia, nearsightedness) but have trouble seeing objects and written words close up (hyperopia, or farsightedness). Hyperopia may impact the child's ability to acquire critical academic skills such as learning to read. Young children may often have a mild degree of hyperopia, which can be normal for their age. Using plus lens glasses at a + 2.50 strength and waiting to start screening at 5 years of age should prevent identifying children with hyperopia that may be normal for their age.

Visual acuity is checked at the same 10-foot distance as for distance visual acuity (myopia, nearsightedness).

A pair of +2.50 glasses. Visual acuity chart.

Screener qualifications
Can be performed by screeners with recommended training.

Same as checking for visual distance acuity, myopia.

A pair of +2.50 glasses are placed over the child's eyes without occluding either eye. The child is asked to read the line (or the higher of the two lines) they passed on the eye chart while standing at the 10 foot distance from the chart.

Blurring of vision (unable to identify optotypes) with the +2.50 glasses.

Clear vision with +2.50 glasses. This indicates the child has a high amount of farsightedness and needs to be referred for evaluation.

If a child has an excessive amount of hyperopia (farsightedness), the child will still be able to see with the +2.50 glasses while viewing the chart used for distance screening. Referring this child for a complete exam will allow for evaluation of high hyperopia and a determination of whether glasses are needed.

Children with little to no refractive error will find the additional +2.50 lenses to be overwhelming and, therefore, blurry for distance viewing. They do not need to be referred.

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