Eye Exams at Preschool and School

Vision plays a critical role in the daily function of children, and in academic performance. Decreased visual acuity or a lazy eye (amblyopia) can make the acquisition of learning skills difficult, result in poor achievement in reading and writing, cause fatigue as a result of eye strain and create difficulty in physical and social functioning. An untreated state of "lazy eye" may even lead to blindness. Early detection of visual impairments makes it possible to receive treatment and prevent the difficulties associated with them.

Tests in preschool

In preschool, children aged 3-4 undergo Photoscreening, a test that helps identify risk factors for a "lazy eye", such as crossed eyes or vision acuity differences between the two eyes. The detection of risk factors at a young age enables early diagnosis of vision impairments and increases the chance of success of the treatment and of prevention of irreversible damage to the vision.

All children whose parents gave their consent to the test in the preschool in their health statement will undergo the test.

Those who are not in preschool during the test can complete it in preschool on another date, or will be referred to a site that performs supplementary tests.

Testers

A trained screener qualified to perform the test.

Course of the test and results

The test is done using a photoscreener for children, which resembles a camera and tests the eyes from a distance and without any physical contact.

Updating the parents and continued monitoring

• Report to parents: in the end of the testing day, the parents will receive a report on the test and its results.
• Referral if necessary: if a visual impairment is suspected - parents will be sent a written referral for continued monitoring and testing by the ophthalmologist who treats the child in the HMO.  If the child is not tested for any reason - the parents will be sent a recommendation to do the test in the HMO.
• Documentation: test results are documented at the Ministry of Health (but are not sent to the HMO).
• Continued monitoring: the service provider will contact the parents to verify the results within 3 months of the test done in preschool.

Who is excluded from the vision test

• Anyone previously diagnosed with a visual impairment.
• Children in special education.

For information and inquiries

You can contact Milgam - Sunday through Thursday 8:00 - 17:00, Friday 9:00 - 12:00, by telephone 073-2088430 or email sight@milgam.co.il.

Tests in school

As part of the vision screening performed at school, an eye exam is conducted in the first and eighth grades to detect pupils suspected of having visual impairments that may affect their general function as well as their academic achievements. The eye exam in first grade is performed near the beginning of the school year, in order to detect and treat a lazy eye as soon as possible.

Pupils in the first grade or eighth grade who are not at school when the screening is performed will be able to complete the test that year at a nearby school on the day eye examinations are performed, or at sites that perform the supplementary tests (student health services usually given in the afternoon or during school vacations) for which parents will be sent an invitation to test. The test may also be completed the following year, in the second grade or ninth grade, respectively.

Testers

• A nurse who works in student health services has been trained to perform vision screening tests at school.
• Optometrist.

Course of the test

An eye exam examines visual acuity and the ability to diagnose lazy eye:

• Visual acuity: ability of the eye to identify items of various sizes. The smaller the detail the eye detects, the better the visual acuity.
• Lazy eye (amblyopia): a decrease in the visual acuity of one eye that cannot be corrected and that does not result from structural defects in the eye.

Before the test, pupils are given an explanation in class about the course of the test and its importance, and how to keep the eyes healthy, and can ask questions about the subject.
The test is performed in a room where the privacy of the pupils is protected. The pupils sit in front of a board on which rows of numbers or shapes of different sizes are marked. The pupil will be asked to read the numbers or note the shapes from large to small, once with the right eye covered and once with the left eye covered.

Even when the vision test performed at school comes out normal, if the parents or the educational staff suspect that the pupil has a visual impairment, the parents will be referred for further medical testing.

Continued monitoring

The school nurse or the party conducting the test will make sure that the pupil has a follow-up eye exam within two months from the date of the test performed at school. The parents may also contact the nurse and report the follow-up test results. The results of the follow-up test will also be documented by the Ministry of Health.

Who is excluded from the vision test?

• Anyone who brings documentation of a vision test performed within the past year.
• Anyone previously diagnosed with a visual impairment. In such a case, the parents will be sent a recommendation to come once a year for vision monitoring at the HMO.
• Pupils in special education will undergo a vision test before arriving at the placement committee and before entering the special education system.

For information and inquiries

You can contact the school nurse or the school's healthcare provider.

List of providers by area

Advice on Eye Health Maintenance

• Reduce screen time and take frequent breaks while using screens to protect your vision.
• Go for outdoor activities to allow your eyes to focus on distant objects (as opposed to screens) to reduce the risk of nearsightedness. Additionally, it is important to get natural daylight exposure to help produce vitamin D and improve sleep quality.
• Refrain from using screens approximately one hour before sleeping.
• Ensure sufficient sleep, which allows the eyes to recover from daily stimuli. Recommended sleep hours are:
  Children aged 3 to 5: 10-13 hours
  Children aged 6 to 13: 9-11 hours
  Children aged 14 to 17: 8-10 hours
• Try to eat a balanced diet that includes vitamins and minerals beneficial for eye health.
• When exposed to the sun, it is recommended to wear a baseball cap and use sunglasses to protect the eyes from the sun.

Signs that may indicate vision impairment

If you notice one or more of the following symptoms in your child, it is advisable to consult a pediatric ophthalmologist:

• Head tilt.
• Covering or shutting one eye during reading or using screens.
• Squinting or furrowing the forehead when looking at a distant object.
• Holding objects in an unusual position.
• Getting closer to an object they are looking at.