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Pinellas County Schools Leverage Local State Legislation to Help Save Vision for Students

Spot Vision Screener and school nurse

With the WELCH ALLYN SPOT Vision Screener - an easy-to-use instrument-based vision screener. 

Vision screening is crucial for early detection and prevention of vision loss in young children. Failing to detect and treat vision disorders in children may lead to partial or full blindness and may result in issues with child development, academic achievement, self-esteem, social-emotional behavior and juvenile delinquency.1 Based on these severe risks, many states require vision screening to be performed in schools to help identify students who need vision correction.

Key Business Outcomes

PCS requires students to meet state guidelines for vision screening. This policy mandates vision checks in all students in kindergarten, first, third, and sixth grades.

Early intervention is the key to success for students. By screening their vision earlier, we can intervene sooner and hopefully prevent them from falling behind in school.


John Foss, LPN

With a large student population, PCS needed a way to perform annual vision screening exams quickly and effectively, and to refer students who needed a full eye exam. A large percentage of students in PCS’ district were covered by Medicaid, which meant PCS wanted to ensure students who were referred had the means to be seen by an eye care specialist and receive glasses, if necessary.

Prior Method for Screening

To test the vision of their entire student population, PCS support staff without a medical background performed chart-based visual acuity testing. According to state guidelines, if a student fails a visual acuity test, the results must be confirmed by a registered nurse. The registered nurse is responsible for following up with the student’s parents to recommend a full eye exam. With such a large student population, having the nurse rescreen failed exams was becoming too time-consuming.

The current process for visual acuity screening consumed time and resources. In most districts, following this process was nearly impossible. Children who were non-verbal, had developmental delays, or spoke English as a second language were difficult to assess using chart-based screens.

Developing a Strategy and Product Selection

PCS needed to improve their vision screening process to ensure accurate and efficient detection of visual impairments. There were a variety of factors that were essential in selecting the right vision screener; the most important being an easy-to-use device that volunteers could use without a lot of room for error. After researching a variety of different companies, PCS selected the Spot Vision Screener based on:

·      Easy-to-use instrument-based vision screener

·      Welch Allyn reputation for quality and dependable products

·      On-site product training

·      Technical support for setup and usage

Project Funding

The Medicaid Certified School Match Program Fee for Service for Nursing provides funding for skilled services to Medicaid-eligible students with individualized education programs. PCS used funds from this program to purchase two Spot Vision Screeners for the vision screening initiative in their district. Leveraging state regulations for vision screening, the Florida Department of Health assisted the vision screening initiative by purchasing two additional Spot Vision Screeners to be used for the PCS district.

Product Training

To avoid the need for multiple tests, PCS provided product training to screeners without a medical background. This allowed the screeners to administer the vision screening exam as accurately as the registered nurse, so the second round of screening could be bypassed.

Follow-up Strategy

PCS implemented a follow-up plan to provide students with long-term benefits. If a student is referred for a follow-up vision exam, the school nurse sends a letter to the student’s parents. If there is no response from the parents, the nurse follows up with a second letter and, if needed, a phone call. This process ensures the child is appropriately referred to an eye specialist. For students without resources to attend a follow-up appointment or purchase glasses, PCS works with the local Bucs Vision Van and the Vision Service Plan (VSP) to provide no-cost services.

The Bucs Vision Van provides screening and eye exams for low-income children.

Results and Enduring Success

Based on PCS’ 2016-2017 school year records, a total of 30,419 students received a vision screening. Of those students, 3,369 (11%) were referred for a follow-up eye exam and a total of 2,060 (62%) successfully received a follow-up exam through a private provider, the Bucs Vision Van, or VSP.

Staff and volunteers found the new vision screening process to be an improvement in accuracy and time management. Instrument-based screening was objective and didn’t require the screener to make assumptions. Clinicians on the Bucs Vision Van reported fewer false referrals with Spot compared to visual acuity testing. They also reported treating patients who were unable to speak English or who had developmental difficulties and were unable to complete visual acuity testing.

Aside from providing an eye screening to students who may not have received one, PCS was able to administer these exams very quickly. The new vision screening program successfully operated with a few PCS support staff and registered nurses and PCS estimates it saved 6 weeks of vision screening time.

Customer Profile

Pinellas County Schools’ mission is to educate and prepare each of their students for the future including: college study, career development and life goals. Serving more than 102,000 students across 140 schools, PCS is the 8th largest school district in Florida (27th largest in the United States).


1. Zaba, Joel N., M.A., O.D., “Children’s Vision Care in the 21st Century and Its Impact on Education, Literacy, Social Issues and the Workplace: A Call to Action,” Sept. 2008.