Vision Screening Requirements

As part of Health and Safety Code, Chapter 36, the Vision Screening Program requires that all children enrolled for the first time in any public, private, parochial, or denominational school or in a Department of Family and Protective Services (DFPS) licensed child care center and licensed child care home in Texas, or who meet certain grade criteria, must be screened or have a professional examination for possible vision problems.

The requirements for vision screening [PDF 584KB] apply each year for children enrolled in any licensed child care center and licensed child care home or school program at the ages or grades listed below: 

Screening Requirements
Who Must Be Screened  When Screening Must Be Done
  • 4-years-old by September 1 
  • Kindergartners
  • Any other first-time entrants
    (4 years* through 12th grade)
Within 120 days of admission 
 1st, 3rd, 5th and 7th graders  Anytime within the school year
(preferably within first semester) 
Although not required by Chapter 36, Department of Family and Protective Services licensed child care center and licensed child care home are encouraged to screen all children younger than 4 years of age who can reliably respond to the screening tests outlined in the Department of State Health Service's vision and hearing screening protocols. 

To collect screening information for each child, a facility may use its own screening form or duplicate one provided by the Department of State Health Services upon request: Vision Screening Form M-60 [PDF 435KB]

In either case, there must be a screening record on file for each child enrolled. The following data must be recorded: Child's Name, Type of Screening, Date, Screener, and Screening Results.

Annual screening results for vision screening activities should be submitted to the Department of State Health Services online on the Child Health Reporting System by June 30 of each year.

Screening Procedures

For vision screening, a distance acuity for the right and left eyes must be recorded, e.g., 20/20, 20/30, etc.  Approved charts for distance acuity testing include: (1) Sloan Letter Chart and (2) HOTV Matching-Symbol Test.

Photoscreening may be used for individuals through five years of age and those with disabilities who do not respond well to other allowable screening methods. If automated screening device is used, pass/fail documentation of results should be recorded. (Muscle balance tests - Hirschberg corneal light reflex and cover-uncover tests - will be included in the certification workshops and are optional tests.) 

Vision Screening Program Recommendations 

In response to stakeholder feedback and as part of HB 3157 implementation activities; the vision screening program convened an expert panel to review evidence-based research, best practices, and professional recommendations related to screening children for vision disorders. 

  • Recommendation 1: School-based screening should focus on monocular visual acuity testing using an approved wall eye chart at standardized distances.
  • Recommendation 2: The Department of State Health Services should continue to use the vision screening guidelines outlined by the American Association for Pediatric Ophthalmology and Strabismus (AAPOS), as the standard procedure for screening school-aged children. 
  • Recommendation 3: Instrument-based screening devices such as photoscreeners should be used in accordance with evidence-based, approved practices based on age and purpose. Instrument-based screening devices may be used to screen for conditions such as refractive error risk factors, medical risk factors such as cloudiness of the lens or other media opacities, retinal or optic nerve pathology and pupil size differences, but are not recommended for screening for visual acuity. Whenever an instrument-based screener is used on children age 6 and older, an approved wall eye chart must also be used. Children with disabilities, who cannot be screened with a wall chart, should be referred for professional examination, regardless of photoscreening result. 
  • Recommendation 4: Computerized visual acuity screeners do not currently have sufficient evidence of effectiveness to be supported by either the AAPOS or this expert panel. An approved wall chart visual acuity exam remains the gold standard at this time.
  • Recommendation 5: The Department of State Health Services will consider use of approved U.S. Food and Drug Administration (FDA) devices that have an FDA designation for targeted age ranges. As new technologies are developed, the Department will consider validated evidence-based research published in peer-reviewed and professionally accepted journals. The Department of State Health Services will routinely monitor professional recommendations and convene experts, as necessary, to assist with review of policies and manuals to make revisions as necessary.

View the November 16, 2017 meeting minutes. [PDF 122KB]

Contact Us

Texas Department of State Health Services
Vision and Hearing Screening
PO Box 149347, MC 1818, Austin, Texas 78714-9347
1100 West 49th Street, Austin, Texas 78756-3199
Phone: 512-776-7420
Toll Free 1-800-252-8023, extension 7420 
Fax: 512-776-7256

Relay Texas: Dial 7-1-1

View List of Vision and Hearing Screening Regional Coordinators.