Maine State
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Summary of the Maine State Guidelines
1. Required Screenings
Grades:
- Distance visual acuity screening is required in Pre-K, kindergarten, and grades 1, 3, 5, 7, and 9.
- Near visual acuity screening is required in grades 1 and 3, and recommended in kindergarten and grade 5 in Maine.
2. Screening Referral Criteria (Criteria for Passing Vision Test)
- Age 3: Referral if unable to identify at least 3 of 5 optotypes on the 20/50 line.
- Ages 4–5: Referral if unable to identify 3 of 5 optotypes on the 20/40 line.
- Ages 6 and up: Referral if unable to identify 3 of 5 optotypes on the 20/32 line.
- Threshold Screening: Refer if there’s a two-line difference between eyes.
3. Children Who Should Bypass Screening
Automatic Referrals:
Students with the following conditions should bypass screening and receive a comprehensive, dilated eye exam:
- Observable ocular abnormalities (e.g., strabismus, ptosis)
- Neurodevelopmental disorders, hearing impairments, cerebral palsy, Down syndrome, autism spectrum disorders, cognitive impairments, ADHD, or chronic conditions like diabetes and juvenile rheumatoid arthritis.
- Family history of strabismus or amblyopia.
- Complicated birth history, such as delivery before 32 weeks or exposure to alcohol/drugs in utero.
4. Required Tools OR Important Changes to Tools Used/Discontinued
Approved Tools:
- Distance visual acuity: LEA SYMBOLS® or HOTV charts (for Pre-K and kindergarten); Sloan Letters for higher grades.
- Near visual acuity: LEA SYMBOLS® or HOTV for younger students; Sloan Letters (16 inches) for students age 6 and up.
- Computer-based screening: GLD-Vision® approved for all ages.
- Instrument-based screening: For ages 3–5 or any uncooperative student; devices include Welch Allyn Spot™, GoCheck Kids, and Plusoptix.
Occluders:
- Adhesive patches or surgical tape (all ages)
- Frosted glasses (ages 3–10)
- Specialized occluders (ages 10+)
Environmental Recommendations:
- Use lighted rooms with minimal glare and distractions.
