005.28.22 Ark. Code R. § 001 - Rules Governing Eye and Vision Screening Report in Arkansas Public Schools

ARKANSAS DIVISION OF ELEMENTARY AND SECONDARY EDUCATION RULES GOVERNING EYE AND VISION SCREENING REPORT IN ARKANSAS PUBLIC SCHOOLS

May 2, 2022

1.0 PURPOSE

The purpose of these Rules is to establish the requirements and procedures for governing eye and vision screening procedures and test standards in Arkansas Public Schools.

2.0 REGULATORY AUTHORITY

These Rules are enacted pursuant to the authority of the State Board of Education under Ark. Code Ann. §§ 6-18-1501et seq. and 25-15-201 et seq.

3.0 DEFINITIONS

For the purpose of these rules, the following terms mean:

3.01 "Commission" means the Arkansas Commission on Eye and Vision Care of School Age Children, which is established by the State of Arkansas to study the eye and vision needs of school age children, evaluate current vision screening programs, and make recommendations to develop a strategic state wide plan to ensure adequate eye and vision care for the school age children of Arkansas.
3.02 "Division" means the Arkansas Division of Elementary and Secondary Education.
3.03 "Screening" means to test in order to separate according to skills or ability.
3.04 Vision Care Consultant means an optometrist or ophthalmologist.
4.0 VISION SCREENINGS / APPROVED INSTRUMENTS
4.01 All students in pre-kindergarten (PK), kindergarten (K), grades one (1), two (2), four (4), six (6), and eight (8), and all transfer students shall receive an eye and vision screening.
4.02 The requirements in these Rules apply to students attending all public schools and public charter schools.
4.03 Nothing in these Rules shall preclude voluntary screening of any educational grade or preclude the referral of any student, regardless of grade, who the teacher or school nurse feels should be screened or examined.
4.04 The responsibility for the enforcement of these Rules rests equally with each school district or charter school and the parent or guardian of the student.
4.05 The Division and Commission establish in these Rules the tests, procedures, equipment, and instruments that shall be used to perform eye and vision screenings.
4.06 The approved screening process will include the following:
4.06.1 Observation and external inspection of the eye;
4.06.2 Distance visual acuity test using a Snellen Eye Chart at twenty feet (20') or an age or developmentally appropriate chart at ten feet (10') outside a vision-screening instrument;
4.06.3 A plus lens visual acuity test using a Snellen Eye Chart at twenty feet (20') or an age or developmentally appropriate chart at ten feet (10') outside a vision screening instrument;
4.06.4 Lateral muscle balance test at far;
4.06.5 Vertical muscle balance test at far;
4.06.6 Fusion or binocularity at far;
4.06.7 Lateral muscle balance test at near;
4.06.8 Fusion or binocularity at near; and
4.06.9 Color perception.
4.06.10 Screening instruments and equipment must be approved. These instruments may include, but are not limited to the following:
4.06.10.1 Titmus Vision Screener;
4.06.10.2 Keystone Vision Screener;
4.06.10.3 Optec Vision Screener;
4.06.10.4 Slides necessary to perform required test;
4.06.10.5 Occluder;
4.06.10.6 Plus 2.00 lens;
4.06.10.7 Snellen Chart;
4.06.10.8 Age appropriate vision screening chart;
4.06.10.9 Color perception booklet/instrument slide;
4.06.10.10 Automated testing instrument (auto refractor); and
4.06.10.11 Other approved instruments.
5.0 SCREENING
5.01 The Division and Commission shall set forth the following criteria for passage or failure of a vision screening and criteria for referral for a comprehensive eye examination:
5.01.1 External Observation: Any obvious anomaly of the eyes or periocular areas should cause referral for medical evaluation. Abnormal head positioning, such as a chronic head tilt, should result in a failed screen. Obvious misalignment of the eyes should result in a screen failure.
5.01.2 Vision at 20 feet or 10 for age appropriate charts: Any eye with vision less than or equal to 20/40 shall result in a screen failure.
5.01.3 +2.00 lens test: Any student that improves 2 or more lines of vision, such as 20/40 to 20/20 with the +2.00 lens in front of either eye, shall result in screen failure.
5.01.4 Color Perception Test: This test shall be performed using an instrument slide or color-testing booklet or color perception slides. Any student missing more than 25% of the cards or instrument slide would be deemed a color perception screen failure, but not referred for comprehensive eye examination. The parent and teacher shall be notified of the color perception screening failure.
5.01.5 Passing or failing the following instrument screenings:
5.01.5.1 Lateral Muscle Balance at far;
5.01.5.2 Vertical Muscle Balance at far;
5.01.5.3 Fusion at far;
5.01.5.4 Lateral Muscle Balance at near; and
5.01.5.5 Fusion at near.
5.02 Public schools may utilize an automated testing instrument to conduct the required vision screening tests for all students in Pre-Kindergarten through grade twelve (12), subject to the following:
5.02.1 The instrument must check distance vision and both lateral and vertical muscle balance;
5.02.2 Other tests required by these Rules must be completed using the standard screening methods, if possible; and
5.02.3 Districts that choose to utilize an automated screening instrument (auto refractor) must use the following protocol:
5.02.3.1 If a student fails with use of the automated instrument, the student must be re-screened with the standard school screening method when possible; and
5.02.3.2 Use of the automated screening instrument shall be documented in eSchool.
5.03 The Division and Commission shall develop standards for training school nurses to perform eye and vision screenings that include, but are not limited to, the criteria set forth in Section 5.01 and 5.02 of these Rules.
5.04 An eye and vision screening report shall be sent or given to each parent or guardian of each student in need of a comprehensive eye and vision examination that has failed a second vision-screening test.
6.0 EYE EXAMS
6.01 A student who does not pass the eye and vision screening tests, except for the color perception test, shall be required to have a comprehensive eye and vision examination conducted by a vision care consultant within sixty (60) days of receipt of the vision screening report identifying the need for the examination.
6.02 The parent or guardian of the student shall be responsible for ensuring that the student receives the appropriate eye and vision examination.
6.03 The local school district shall take such action and access all resources necessary to encourage that the student receives an appropriate examination. If a student does not receive an appropriate examination, as evidenced by a certificate signed by a vision care consultant acknowledging the examination, then the school where the child is registered shall report this to the Division.
6.04 A student who has had a comprehensive eye and vision examination conducted by a vision care consultant within six (6) months of an eye and vision screening is not required to have another examination if the parent or guardian of the student presents evidence of a comprehensive eye and vision examination in the form of a certificate signed by a vision care consultant acknowledging the examination.
6.05 Transfer students who have been screened in their previous school during the current school year do not have to be rescreened at the new school. Schools may request the transfer student's vision screening from his/her school that was completed within the current school year.
7.0 FORMS
7.01 The Division, in conjunction with the Commission, shall develop standardized forms to be used in conducting and reporting the results of eye and vision screenings.
7.02 The standardized forms shall include:
7.02.1 A vision screening form;
7.02.2 A parent notification form;
7.02.3 A doctor report form;
7.02.4 A form to report the results of screening and examination; and
7.02.5 Any other forms deemed necessary by the Division or Commission.
7.03 Every public school shall use the standardized forms for eye and vision screening reports.
8.0 TRAINING
8.01 The Division, in conjunction with the Commission, shall develop standards for training school nurses to perform eye and vision screenings.
9.0 REPORTING
9.01 Each public school shall de-identify eye and vision screening results as necessary to comply with privacy laws and report the results by grade to the Division and Commission.
9.02 The report shall include the following information:
9.02.1 The number of students screened;
9.02.2 The number of students re-screened;
9.02.3 The number of students who did not receive an eye and vision screening;
9.02.4 The number of students referred for a comprehensive eye examination;
9.02.5 The number of students who failed the eye and vision screening who did not receive a comprehensive eye examination; and
9.02.6 The comprehensive eye examination will be reported as normal or treatment required.
9.03 Eye and vision screening shall be completed annually and reported to the Division in Cycle 7 reporting (by June 15th) of each school year.
9.04 Annually, the Commission and Division shall report its findings and updates to the Governor, the Legislative Council, and the House and Senate Committees on Public Health, Welfare, and Labor.
10.0 CONSULTANT

Each school district is encouraged to select one (1) or more vision care consultants to serve as non-paid eye and vision care consultants to provide advice and assistance with eye and vision screenings and examinations.

Notes

005.28.22 Ark. Code R. § 001
Adopted by Arkansas Register Volume 47 Number 05, Effective 5/2/2022

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