Open Your Eyes: MDH Releases New Vision Screening Guidelines


MikeSeversonBy Michael Severson, MD, FAAP; Susan Schloff, MD, FAAP; Faith Kidder, APRN, CPNP, MS, PHN, Minnesota Department of Health

The Minnesota Department of Health (MDH) recently updated its vision screening guidelines and best practices in a succinct, easy-to-access document for providers who do not have the time nor the need to scan a procedure manual.

Developed by a cross section of screening entities and professional organizations, including Dr. Mike Severson representing the Minnesota Chapter of the American Academy of Pediatrics, the document provides at-a-glance information about recommended vision screening procedures for children post newborn through age 20.

In Minnesota, the number of kids who receive vision screening is above the national average. Still, many kids pass when they need further testing. The new guidelines direct practices, schools and early childhood programs to use correct methods to ensure accurate, reliable results.


Overview of changes to MDH guidelines:

• Adds AAP risk factors requiring referral rather than screening
• Suggests different eye occlusion strategies — because kids peek!
• Changes the screening distance for all children to 10 feet per AAP recommendations
• Updates pass criteria for 3-year-olds
• Allows 3 to 5-year-olds to miss one of any HOTV or Lea symbols
• Replaces Snellen chart for older children with Sloan Letters chart.
• Adds screener qualifications for each procedure (this is mostly for screening programs to follow; provider would still be required by Child and Teen Checkups to do a complete eye exam).
• Replaces the cross cover screening for screening programs with the uncover screening.
• Adds recommendations for instrument-based vision screening.

The U.S. Preventive Services Task Force recommends vision screening for all children ages 3 to 5 years to find conditions such as strabismus or refractive error that contribute to the development of amblyopia. Amblyopia can only be treated effectively if caught early.

Impaired vision in children can contribute to the development of learning problems which may be prevented or alleviated through early identification and intervention. Amblyopia, for example, is impossible for parents or providers to detect by casual observation. A careful vision screen allows early treatment—the best option for complete cure.

With prompt referral and follow-up, Minnesota children have an opportunity to receive appropriate and timely care and services which lead to better health and educational outcomes.

Be sure you and your team check out the new guidelines (due to be posted by 8/31/2015) at
For more information, please contact the Minnesota Department of Health Child and Teen Checkups program at or call (651) 201-3650.

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