Faking on vision screens

FolksBtrippin, BSN, RN · Sep 16, 2017

I think you need to refer his parents to a pediatric opthamologist.

You're doing a vision screening, not a diagnostic test.

He is failing your screening. You don't have the equipment or expertise to determine why.

Jolie, BSN · Sep 16, 2017

My confidence is wavering since I feel I blew it this time around and should've already called him out on it - still very new at this!

This part of your post bothers me. Why does a questionable screening effect your confidence, and why would you "call out" a 10 year old who didn't respond as you expected to a vision screening?

There could be a thousand reasons for a child to fail to read an eye chart, ranging from boredom, to feeling uncooperative, to embarrassment over poor letter recognition, to trying to act cool in front of classmates, etc., etc., etc.....It is even possible that he really CAN'T read the letters due to visual changes that may accompany rapid growth or the unrecognized onset of a health problem like diabetes.

Please gather as much information as possible from his teachers, re-screen him compassionately and in private, and if necessary, have a gentle conversation with him explaining your concern for his well-being, and need the need to contact his parents.

None of this reflects on you. Please set your confidence aside and keep your focus on your student.

peacockblue · Sep 16, 2017

Some kids do deliberately fail vision screenings because they want glasses. Their best friend may have just got them and they think they look cool. That is not your determination to make. We do a screening, not a comprehensive eye exam. That is why we refer. You may have caught something major or the kid could have been bamboozling you. Either way you did your job. I am responsible for doing about 1400 vision screenings every year. I would rather refer someone who didn't need referred than miss something that could be corrected.

kidzcare · Sep 16, 2017

I just had a situation with a kid deliberately failing his hearing screening. He claiming not to hear at 80 decibels. I asked him to stay back while his peers went back to class, explained to him the rules again (he said he thought I told him only to raise his hand when he heard the first beep), and tried again.

I would rescreen and gently, but pointedly, say "It's surprising that you cannot read the top line since you didn't have any problem seeing the clear tape on the ground. Why don't you go rinse your eyes in the bathroom and then we'll give it one more shot" This isn't directly calling him out but (if he is faking) then he will know that you are suspicious. Having him go rinse his eyes gives him a moment to cover any embarrassment and have a built in excuse if his vision is miraculously better.

cincyredsfan · Sep 18, 2017

I got glasses from our local Optometrist with plain glass lenses. If I think the student is pulling my leg, I have them put those glasses on and ask them if that makes it any better. If it does, I know they're faking and I let the parents know that. If not, I refer them. It saves the parents a trip to the Dr. I may or may not have been one of the kids that always wanted glasses. :yes:

OldDude · Sep 18, 2017

I got glasses from our local Optometrist with plain glass lenses. If I think the student is pulling my leg, I have them put those glasses on and ask them if that makes it any better. If it does, I know they're faking and I let the parents know that. If not, I refer them. It saves the parents a trip to the Dr. I may or may not have been one of the kids that always wanted glasses.

I use the fake glasses too, that usually nails it. I also play a game where I pick a letter they can read and tell them I challenge them to see how fast they can react, by telling me what it is, when I touch the letter. As the game progresses I cheer them on and tell them I don't think I've ever seen anyone as fast as they are. I slowly move down the chart as the game goes on and, in many cases, they've forgotten about being blind and have engaged in the game which ultimately proves out to be a passing screen.

OyWithThePoodles, RN · Sep 18, 2017

I use the fake glasses too, that usually nails it. I also play a game where I pick a letter they can read and tell them I challenge them to see how fast they can react, by telling me what it is, when I touch the letter. As the game progresses I cheer them on and tell them I don't think I've ever seen anyone as fast as they are. I slowly move down the chart as the game goes on and, in many cases, they've forgotten about being blind and have engaged in the game which ultimately proves out to be a passing screen.

OldDude, you so smart.

Flare, ASN, BSN · Sep 18, 2017

i have never thought to get a pair of fake glasses - you guys are flippin' geniuses! I am stealing that one :inlove:

Farawyn · Sep 18, 2017

OldDude, you so smart.

And handsome. :blink:

janetpa · Sep 18, 2017

The same thing happened to me--I had three girls (all friends) who were I thought were faking the eye exams. I called their parents and explained my reservations---I also lectured the girls about how expensive eye exams are etc--(trying for a guilt trip) The next day they all came to school with designer frames, no glass. Parent explained that the girls just wanted the frames to match each other. No eye exam necessary as they admitted faking the test.

Amethya · Sep 18, 2017

I had the same issue, and the mother knew too. She came in after school with the child and we did the exam there, the child still said she could not see. I just told the mom to take her to the doctor. She went and no glasses, she was so disappointed, so I just told mom to buy her fake glasses and was super happy afterwards.