Prevent Blindness Ohio: Survey - PBO Vision Screening Recertification True-False Exam School

Instructions

Please answer the following questions. You may submit your test online or print and return this test to Wendy Klein at Prevent Blindness Ohio, 1500 W. Third Avenue, Columbus, Ohio 43212. Tests may also be faxed to Wendy's attention at 614/481-9670.

It is important that you take the time to read through both the Preschool Vision Screening Guidelines manual and the Preschool Vision Screening for Healthcare Professionals manual. There are several subtle differences between the two documents. The reason that they are both being used is that the Preschool Vision Screening Guidelines manual specifies the guidelines to be used if you work in a school environment or are a community volunteer. The Preschool Vision Screening for Healthcare Professionals manual specifies the guidelines to be used if you work in a healthcare setting.

Please provide the following information before starting the test.

Name:

Title	First Required	Middle Required	Last Required	Suffix

Email: Required

Street 1: Required

Street 2:

City/State/ZIP:

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Country:

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Occupation:

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Question - Not Required - Company/organization (if applicable)

Question - Not Required - If you are a primary care provider, do you accept Medicaid patients?

*4.

Question - Required - Date of Vision Screening Training

Month

Day

Year

True/False Exam

*5.

Question - Required - An estimated one in thirty pre-school aged children have a vision problem.

*6.

Question - Required - Undetected and untreated amblyopia, commonly called lazy eye, can lead to permanent vision loss.

*7.

Question - Required - Strabismus or crossed eye is a possible cause of amblyopia.

*8.

Question - Required - A child who wears prescription eye glasses should take them off to be screened.

*9.

Question - Required - The passing line on the Lea acuity chart is the 20/32 line.

*10.

Question - Required - Always check the right eye before the left eye when screening for acuity.

*11.

Question - Required - A child who consistently tilts his/her head to one side should be referred for an examination.

*12.

Question - Required - Children must correctly identify the symbol four times in a row out of 4 attempts to pass the Random Dot E stereopsis test.

*13.

Question - Required - To pass a line on a Lea visual acuity chart, a child must correctly identify three out of five symbols on that line.

*14.

Question - Required - The Random Dot E Test is conducted at three (3) feet, according to the Ohio Department of Health Preschool Vision Screening Guidelines.

*15.

Question - Required - You cannot refer a child for an eye exam based only on an observation.

*16.

Question - Required - Complaint from the parent that his/her child gets headaches is not sufficient reason to refer the child to an eye care professional or primary care physician.

*17.

Question - Required - Children are often unaware of signs of a possible vision problem.

*18.

Question - Required - For proper visual acuity testing with a 10-foot light box chart, have the child stand with toes on a line, or place the happy/magic feet toes, 10 feet from the chart.

*19.

Question - Required - Children unable to read the passing or critical line on the visual acuity chart on the first attempt are re-screened or referred if the screener does not have immediate access to rescreen the children.

*20.

Question - Required - Cleaning the equipment in between screening children is not a necessary part of a Prevent Blindness America Children's Vision Screening Program.

*21.

Question - Required - Ideally, re-screening is the appropriate outcome for a child who completes the 20/32 line on a Lea chart with both the right and left eyes on the first attempt.

*22.

Question - Required - A child must have the visual acuity of 20/32 or better in each eye to pass the acuity screening.

*23.

Question - Required - Follow-up to confirm that referred children have seen an eye doctor is a required component of Prevent Blindness America Children's Vision Screening Program.