Strabismus Referral?

[Supernrse01, BSN]

Good morning. This is my first year working as a school nurse. I was doing an IEP vision/hearing screening on a student with an obvious strabismus. He passed the eye exam and states that he does not wear glasses. Do I send a referral letter home even though he passed the exam? (Our schools keep the students pictures from year-to-year and it seems to progressively get worse) Thanks all!

[safarirn]

Yes. Remember, you can base a referral on observation.

[Supernrse01, BSN]

Thanks so much. I knew that but sometimes just need that second opinion

[safarirn]

That's why I LOVE this forum!

[morte, LPN, LVN]

remember that some kids will memorize the eye chart, or at least parts of it...lol....

[Supernrse01, BSN]

LOL... that's true and I hadn't thought of that. I have already made the referral and I spoke with student's mom this morning. Said she hasn't even noticed his eye which is amazing.

[bergren]

The problem with strabismus, is if it is not detected or corrected, in an attempt to avoid double vision, the brain will eventually disregard the image of one eye (called suppression) . http://www.strabismus.org/

Your state schould have a protocol for vision screening - some states have required training:

check with your state organization http://www.nasn.org/Default.aspx?tabid=60

or your state school nurse consultant: http://www.nassnc.org/?q=node/26

The NASN Issue Brief on Vision Screening has a lot of good information:

http://www.nasn.org/Default.aspx?tabid=284

NASN also has a manual:

To See or Not To See - Screening the Vision of Children in School

https://nasn.networkats.com/members_online/members/viewitem.asp?item=S011&catalog=MAN&pn=1&af=NASN

[Supernrse01, BSN]

Thanks Martha. I did inform the Mother about the supression and the need to have him checked out. Thanks for the links, I'll check them out