“Those who were skeptics now understand why I pushed for this program. Now when we request a vision evaluation for a child, we feel like we can back up the request.” - J.L., Greenville MS

Despite legislative efforts to improve school vision screening, professional efforts to promote vision care for children and most educators’ appreciation of the need for students to see well in class, far too many students still have vision problems. The scope and effectiveness of school vision screening programs is often diluted by accommodating both optometric and ophthalmologic sensibilities and the limited additional time and effort which can be expected of school nurses to do a more thorough screening. In addition, vision screening is compartmentalized as a school health requirement and not an educational initiative, so school-wide appreciation of vision issues may not be in place. Lastly, if a better screening is performed, will more students make it to the eye doctor more quickly? As many eye doctors know, referred students may not present for an examination for months or even more than a year after the school’s vision referral. The Vision Council of America estimates that 40% to 70% of children do not receive follow-up care from an eye care professional after a failed screening!

VERA helps to overcome obstacles to better vision screening and referral fulfillment: VERA’s universal routine screening generates referrals for the entire vision care community. Since the vision skills screening has an optometric bias, we offer VERA SE, which contains only the universal routine screening. Since VERA requires no new clinical skills of school nurses, the program is easily accepted.

Schools using VERA report many additionally fulfilled referrals owing to the program’s accuracy, personalized reports and letters and follow-up capabilities. Professional, attractive screening reports to parents and eye doctors make the school’s commitment to better vision evident to the community. Other reports facilitate the nurse’s sharing of information about a student’s vision with teachers and administration easier, so they too can encourage compliance with the referral and better accommodate students whose vision remains uncorrected. VERA can increase the number of referrals for vision care and also encourage schools to position vision as a more integral part of the learning experience.

We hope you’ll feel confident about recommending VERA’s universal routine screening (VERA SE program) to your community schools. If your practice includes treatment of vision skills or you are able to refer for these issues, we hope you’ll recommend both the routine screening and the skills screening (VERA 3 program). For additional information on presenting VERA to schools, Contact Us.

VERA research: Experience from nearly one million VERA screenings has refined the routine screening process. The result has been consistent identification of refractive and basic binocular vision issues which would have been missed by eye charts and most traditional screening methods.

Initial VERA research has shown that static screening tests (those that require only one subject response) have little correlation to reading and/or learning ability. Research showed that computerized visual performance testing (requiring responses to critically controlled demands over time) correlated well with learning-related vision problems and the results of complete, professional vision examinations. The company was awarded two patents for this method of identification (and subsequent treatment).

More recent research defines VERA's accuracy in identifying students with visual skills problems when compared to teams of vision and reading specialists assessing the same students. Despite the overlap of vision skills issues with behavioral complexes like ADHD and perceptual complexes like dyslexia., VERA identified students with visual skills problems with approximately 60% sensitivity and nearly 90% specificity when combined with its symptom survey.

Practical experience has proven that, when adhering to VERA protocols, students with previously undetected learning-related vision issues have been correctly identified and referred by schools for evaluation and treatment. Afterwards, academic performance and reading ability has improved and the schools have saved special educational resources.

This is powerful information for the school to offer parents of affected students and to it’s pupil support or pupil review teams when recommending special education services and/or community vision care options. As far back as 1999, the national PTA estimated that 10 million children suffer from undetected visual skills problems due to the lack of appropriate evaluation. Using this example, it would be likely that about 6 million of them would be identified by VERA with over 80% certainty. Of the remaining 4 million, many would be classified by VERA as "questionable" and about half of these students would be likely to have a vision skills problem on subsequent examination.

VERA in a professional office: The routine screening component of VERA can be used as a pre-examination screening for visual acuity, hyperopia and binocular vision for patients of any age. As an institutional screening tool, the program may differ from your usual clinical testing as follows:

The visual acuity screening has test lines which correspond to 20/20, 20/25, 20/30, 20/40, 20/70, 20/200 and 20/400. Other lines have been omitted to render an institution’s vision screening more efficient without changing the pass/fail accuracy. Nonetheless, the program will give you an accurate gauge of whether your patients visual acuity requires correction and whether the vision skills screening can be run at the same time.

The routine binocular vision screening includes test for suppression, stereopsis and phoria which are not scored individually. Passing the binocular screening requires passing any 2 of the three tests. As such, the program will give you an indication of whether additional binocular testing is advised.

The vision skills component of VERA can be used as a screening for the relative ease with which your patient with normal or corrected visual acuity exercises their visual skills. This can give you, your patient and their parent(s) an indicator of the potential benefit of vision therapy. The scoring of the visual skills screening is age-dependent and calibrated for ages 7-13. Younger patients may have a developmental lag and so results may be equivocal, and older patients may be less amenable to therapy or school support in the absence of professional care. Older patients may still be screened with VERA; their results will be compared to the oldest students in the database and still give reasonably accurate results.

The entire screening can be run by an assistant and any areas of potential weakness displayed in the screening report can then be confirmed during your examination. If your practice does not provide vision therapy services, you'll be able to screen your young patient for a visual skills deficiency and make an appropriate and appreciated referral with a minimum of time and effort.

Please download our demonstration program, which is the full screening with fictitious students in the database, to review the vision skills tests and how they are run. A shortcut to the VERA manual in .pdf form will be placed on your desktop.