Vision screen form 2025

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The document is a Certificate of Record for Vision Screening and Eye Examination, detailing the results of various vision tests conducted on a child. It includes sections for recording the child's name, birthdate, age, and results from distance acuity screens, automated screening devices, and other vision tests. The document emphasizes the importance of follow-up evaluations by a primary care provider if any issues are detected during screening. Additionally, it contains a waiver section for parents to acknowledge their child's ongoing eye care.

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What happens at a vision screening?

A vision screening is a brief test that mainly checks how well you can see things up close and far away. Its also called an eye test. The test usually involves reading letters on an eye chart. A vision screening is a quick way to find out if you need a comprehensive (complete) eye exam.

What is a routine vision screening?

Routine/General exams: These are like a routine physical or checkup for your eyes. These happen regularly for people with no eye conditions or who just need corrective lenses. Follow-up exam: This is a more specific type of exam. You might have one to follow up after a previous eye injury or procedure.

What is the most commonly used tool for vision screening?

Understanding Your Vision Clear Vision. Clear vision in the normal eye results from light rays passing through the cornea, pupil and lens, and focusing directly on the retina. Myopia (nearsightedness) Hyperopia (farsightedness) Astigmatism.

What does a typical eye exam include?

The Big E chartor Snellen eye chartis the most familiar type of visual acuity test.

What does a vision screening consist of?

Eye care providers might use certain charts for measuring distance vision and others for measuring near vision. Some eye charts are especially for children while others work for both children and adults. The Snellen eye chart, however, is the most common and the most recognizable.

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