RILSF Vision Screening in Schools

The Rhode Island Lions Sight Foundation (RILSF) conducts vision screenings exclusively using Welch Allyn Spot Vision Screeners. While some local town Lions clubs can perform testing using Titmus machines (an electronic method similar, but not identical, to Snellen chart testing), the RILSF does not schedule or provide that type of testing.

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Per Rhode Island Rules and Regulations for School Health Programs (216-RICR-20-10-4, Section 4.13), if an RILSF screening indicates that a student requires further evaluation, the school nurse must conduct follow-up testing (visual acuity tests) before a student is referred to an eye doctor for a complete exam. 216-RICR-20-10-4, Section 4.13 has information on how this follow up testing should be conducted. 

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If you would like to proceed with scheduling a vision screening with the RILSF, please review the requirements and procedures outlined below.

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Information Required for Scheduling

To schedule a screening, the RILSF requires the following information:

• School nurse's name and email address

• School name and physical address

• The estimated number of students to be screened (Rhode Island regulations require annual screenings for grades 1–5, 7, and 9). This estimate must be within 50 students of the actual total, as it dictates the number of screeners deployed.

• 3 to 4 preferred dates for the screening (listed in order of preference). Dates should typically about one week apart and not all the same day of the week. The dates should be approved by the school's administration. 

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Scheduling Limitations:

• Date Selection: Fridays are not recommended for inner-city schools due to high absenteeism. Avoid scheduling on days immediately preceding or following a holiday.

• Timeline: Scheduling begins in late August after the school year starts. Because RILSF equipment is loaned out to local Rhode Island Lions clubs for their own local school screenings, the RILSF typically does not schedule screenings until after mid-November.

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Screening Room and Lighting Requirements

The Spot Vision Screener takes rapid readings by looking into the student's eyes. The process is exceptionally fast, typically taking less than 30 seconds per student. However, if a student wears glasses or has severe vision irregularities  (for example, if a student has very poor eyesight and does not yet have glasses) obtaining readings can take longer

Because the device makes the measurements through the student's pupils, larger pupils make readings significantly easier to obtain. Therefore, your selected screening location must satisfy the following conditions:

• No Direct Sunlight: This is a critical requirement.

• Window Blinds: If windows are present, they must be covered with blinds. Room-darkening blinds are highly preferred. There must be no light gaps along the sides or bottoms of the blinds; otherwise, screening students who wear glasses can become nearly impossible.

• Artificial Lighting: Standard overhead fluorescent lights are acceptable provided the overall illumination is not excessively bright

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Volunteer Staffing and Confirmation Process

1. Initial Request: When a school nurse contacts the RILSF to request a screening, if they are new to requesting the RILSF's help, they will receive an initial email containing the guidelines detailed in this document.
   Once a nurse has supplied the number of students to be screened and the possible screening dates, a date is chosen and a confirmation request is sent to the nurse. 

2. Staffing the Event: Once confirmation of the tentative date is received, the RILSF will secure volunteers. The standard staffing ratio is one screener per 100 to 150 students, typically allowing the screening to be completed within 1 to 1.5 hours.

3. Confirmation (2nd Email and meeting invite): Once enough volunteers are secured, a confirmation email will be sent to the school nurse and carbon-copied (Cc'ed) to the screeners. This email will confirm the final student count, the number of screeners, the screeners' names, the school name and address, arrival and start times, and additional instructions.
   A Google meeting invite will be created for the screening, inviting the school nurse, the screeners, and any other necessary persons. 

4. Reminder (3rd Email): If it is felt necessary, approximately one week before the scheduled screening, a final reminder email is sent to the nurse and CC'ed to the screeners to verify the school name and address.

 

Day-of-Screening Procedures

• Administrative Awareness: Ensure school administration is fully aware of the screening schedule and arrangements. This safeguards the event in case the school nurse is unexpectedly absent.

• Space Allocation: Each vision screener requires a clear operating space of approximately 8 feet by 4 feet. The room must accommodate an easy flow of traffic for students entering and exiting the screening area.

• Student Roster: The nurse must maintain an alphabetized student list for each class. This list is used to check off screened students and clearly mark individuals who require a rescreening. This is for the nurse so  that the screening goes quickly and efficiently; it  should not be given to the RILSF volunteers. 

• Personnel Support: Because the screening process moves very quickly, the school should provide one person to manage student traffic as they wait and a second person to log data on the tracking sheet (marking who was screened and who needs rescreening).

• Class Coordination: There should be no delays or gaps between classes if possible. A typical class of 25 to 30 students takes less than 5 minutes to screen. Close coordination between teachers and the nurse is essential to ensure classes arrive promptly. When students are lined up and ready, a single screener can test 100 or more students per hour--quick screening minimizes the disruption in the students' school day. 

• Language Accommodations: If students have limited English proficiency, an interpreter (such as a teacher or administrator) should be present in the room to translate instructions.

• End-of-Screening Event Data: At the conclusion of the screening, the nurse must provide the screeners with the total number of students screened and the total number of students recommended for rescreening.
  The volunteers will delete any screening data on the spot cameras. 

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Post-Screening and Compliance Requirements

• State-Mandated Rescreening: If the Spot Vision Screening indicates a reading outside the normal range, the screener will instruct the student to give their name to the nurse for a rescreening recommendation.
  The RILSF strongly recommends that the school nurse perform the state required follow up testing (as described in the state health regulations) before making a recommendation to a students' parents for the student to see an eye doctor. 

• Background Checks (RI BCI): Many RILSF volunteers do not hold a Rhode Island Bureau of Criminal Identification (BCI) background check. If your town or school policy mandates a strict RI BCI for external service providers, you must explicitly notify the RILSF when submitting your preferred screening dates. (Please check your local town policies, as some may be stricter than state law).
  If you  request the screeners have BCIs, only screeners with BCIs will be assigned to your school. 
  Because the pool of volunteers with BCIs is smaller, requiring BCIs can make it harder to find volunteers. 

• Safety of students and volunteers: A school employee must  remain in the screening room at all times when the volunteers and students are together in the screening room.

• Standard Timeline: Unless specialized arrangements are made in advance, vision screeners will arrive at your school at 9:30 AM and remain available to conduct screenings until all students have been screened provided the organization of the screening at the school is reasonable. If screening goes beyond 11:30am, the screeners may have to leave. Either the nurse will have to finish the screenings or reschedule another date. .  

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