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Vision Screening Trickster


Specializes in School nurse. Has 18 years experience.

I have a 4th grade student who I suspect is playing games with the vision screening. She is calling out letters that make no sense at all. For example she said an O was an X . With her Left eye she couldn't even read the top line (20/100). I just have a hard time believeing these are accurate results. What do you think?

coughdrop.2.go, BSN, RN

Specializes in School Nursing, Public Health Nurse. Has 3 years experience.

Have you tested her multiple times with different results? Even if she fails and you think so note that on the referral letter to go home. I have a section on my letter where I make notes such as the student stated the lost the glasses or have headaches, etc. You can also call the parents and ask when was her last eye exam and the results.

CT Pixie, BSN, RN

Has 10 years experience.

I know when my oldest daughter was around that age, the new 'thing' was to have glasses. Everyone wanted them. My daughter had just had a vision screening and it came back better than 20/20 (can't remember exactly what it was) this school screening was prior to her yearly exam w/the peds doc..anyway, fast forward a few a couple of weeks..she's at the docs getting her vision screening.

Doctor calls me into room and explains that from the results of the vision screening my daughter is very close to legally blind. I looked at her and laughed. Doc goes on to say with those results she is required by law to (blah blah blah..can't remember who or what had to be reported) and that she wanted my daughter to go to an eye specialist. I tried explaining that just 2 weeks before her vision was bETTER than 20/20 and that she was probably doing this because she WANTED glasses.

Went round and round with the doc. Finally, my daughter fessed up and admitted she faked her test b/c she wanted glasses. Actually several of the girls in her class pulled the same stunt.


Specializes in Pediatrics Retired.

I have found this technique to be helpful with kids who want to wear glasses. I think I made it up but maybe someone else has done this. You tell the student they have now qualified to do the "timed" vision test so they are going to have to pay close attention and keep up with you on the test. You start out at the normal leisurely pace and then you pick up the speed of pointing out the letters as the screen progresses. At first the child can keep up with "making up" a letter that isn't the letter you are pointing at but soon, since kids are basically honest, they are not capable of rapidly substituting a letter as you jump across all the lines of the chart in a random fashion. As you speed up be sure not to wait for them to say something but move to the next letter to reinforce the urgency of the test. You will find many of them correctly identifying the letters on the passing lines just to try to keep up with your pace; especially if you're a good cheerleader and distract and coax them on.

bluebonnetrn, BSN, RN

Specializes in School nurse. Has 18 years experience.

That's genius OldDude!


I have a pair of "glasses" that have just plain clear glass lenses, no prescription in them. If I suspect a student is just wanting glasses I recheck them with these and ask them if they can see any better with the glasses. It's amazing how those fix their vision problems!

NutmeggeRN, BSN

Specializes in kids. Has 25 years experience.

Call their bluff and ask mom to make an appointment with Ophthalmologist or Optician