House Bill 3157 allows the use of photoscreening devices but does not require their use or purchase. Schools should continue to follow current rules that allow the use of photoscreening technology in accordance with the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) recommendations. (Read additional details about the use of photoscreening below.) 

Yes, photoscreening devices can be used to screen students at any age for risk factors that may lead to vision disorders. However, for children 6 years old and older without a disability, photoscreening does not assess visual acuity. Therefore, to meet current requirements, additional screening using an approved eye chart is needed to assess visual acuity in children aged 5 and older.

Yes, entities not affiliated with the school may perform vision screening.

• Licensed professionals, like ophthalmologists or optometrists, may screen children using acceptable screening procedures as defined under their professional licensure.
• Individuals who are not licensed professionals but have completed appropriate training and are certified by the Texas Department of State Health Services (DSHS), may screen children according to current rules. 

All new technology or methods are vetted within the agency and with experts to ensure they comply with current guidance.  DSHS continually follows AAPOS guidelines and recommendations to determine acceptable visual acuity screening technology or methods. If new technology or methods are deemed to have met AAPOS guidelines, DSHS will update its program rules, as needed, and communicate the new guidance with stakeholders. 

DSHS follows American Association for Pediatric Ophthalmology and Strabismus (AAPOS) guidelines (https://aapos.org/members/policy-statements) for the screening program. Our current interpretation of the AAPOS guidelines is that there is insufficient independent validation of computerized visual acuity screening to have a formal endorsement or recommendation of its use. The DSHS position at this time is that schools use the Sloan Letter Chart or HOTV charts as they are considered the gold standard for screening vision in otherwise healthy school-age children.

DSHS does not promote or endorse vendors or products on the market.  DSHS also does not maintain an approved list of screening devices. Texas schools have the autonomy to choose products that best serve their students, and DSHS will continue to recommend methods that align with AAPOS guidelines.  

Photoscreening is a pediatric vision screening method that uses a specialized camera to assess a child's visual acuity. Other related terms are autorefractor, objective screening, and instrument-based screening. By detecting specific light reflexes from each eye, the devices produce images that can help identify refractive errors (such as a prescription for glasses) and ocular misalignments (such as strabismus). Photoscreening is particularly useful with preverbal children (under age 3 years), young children (age 3 to 5 years), and older, non-cooperative, or non-verbal children. However, photoscreening cannot determine exactly how well a child’s visual acuity is developing. 

Visual acuity is the sharpness of vision, measured by the ability to discern letters or numbers at a given distance according to a fixed standard. The use of an eye chart requires a cooperative child, so successful testing is greatest with children 3 years and older. It is the only screening method that directly measures visual acuity and is the preferred exam for older children.

Photoscreening may be used on children with disabilities, and they should be referred for a professional evaluation if they fail. The expert panel recommendation to refer these children regardless of photoscreening result is not a program requirement, but rather a recommendation of best practices. In other words, schools should consider that a photoscreener does not accurately assess visual acuity in children ages 6 and older. Therefore, at the school's evaluation and discretion, disabled children who pass photoscreening may still need a referral for a more comprehensive eye exam. 

The school will only report the passing result of the photoscreening. 

If you choose not to screen in the Fall semester (by the end of December), you will need to screen your students at the required age.
 

Yes. With the new age requirements, the child will need to be screened at the appropriate age or during the fall semester of the proper grade level.

 

Yes. Your district has 2 options:
    • Screen by age or 
    • Screen by specified grade level in the fall.

 

Yes. Girls will be screened twice, once at age 10 (or the fall semester of grade 5) and again at age 12 (or the fall semester of grade 7).  The extra option of the fall semesters of grades 5 and 7 for girls (and fall of grade 8 for boys) has been added to provide more flexibility for a school-based setting while still closely following the professionally recommended ages, understanding that some students will not be the exact age at that time during the school year.  Remember, however, that any students who fall significantly outside the recommended age range due to grade-level promotion or retention should be screened at the appropriate age.

 

Schools must identify outliers (i.e., students promoted to higher grades or held back) and ensure their screenings align with appropriate ages rather than grades.

 

Yes, the school or district can pick, so long as the student falls within one of the allowed age or grade categories.  The school has the flexibility to screen boys at age 13 or 14, or in the fall of grade 8.  
 

The reporting system will be updated to reflect reporting requirements. We are currently working to make system reporting updates and will provide updates to the schools as they develop. 

 

Schools may encourage, but they cannot require students to be screened.  

Schools can get documentation from parents that spinal screening has been performed by a professional at the appropriate age or fall semester of proper grade level. This may reduce the number of students who need to be screened and prevent unnecessary additional screening.

School administrators may obtain an affidavit documenting that: 
   •The spinal screening will be performed by a qualified individual outside the school. (School administrators
      should obtain further documentation that the spinal screening was performed within 60 days of receiving
      this affidavit.) or  
   •The spinal screening is being declined based on religious tenets.
 

If the student will still be the appropriate age or entering the proper grade level during the first 120 days of the following school year, then the screening may be postponed until that time.

 

Nursing students who meet the qualification criteria and become certified may help school nurses conduct spinal screenings.