Missouri State
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Summary of the Missouri State Guidelines
1. Required Screenings
In Missouri, vision screening is required for specific grade levels to support early identification and treatment of visual impairments in school-aged children.
- Kindergarten
- 1st Grade
- 2nd Grade
- 3rd Grade
- Students new to the district
- Every other year after 3rd grade
Screening types include:
- Distance visual acuity
- Near visual acuity
- Stereopsis (binocular vision)
2. Screening Referral Criteria (Criteria for Passing Vision Test)
Preschool and Kindergarten:
- Each eye must see at least the 20/40 line.
- Two-line difference between eyes (e.g., Right 20/20, Left 20/40) requires referral.
Grades 1–12:
- Each eye must see at least the 20/30 line.
- Two-line difference between the eyes also warrants referral.
Near Visual Acuity:
- Follows the same criteria as distance acuity for each age group.
Stereopsis (Binocular Vision):
- Child must correctly identify the Stereo “E” card in at least 4 out of 5 attempts.
3. Children Who Should Bypass Screening
- Students with documentation of a comprehensive eye exam within the last 12 months may bypass the standard screening process.
4. Required Tools OR Important Changes to Tools Used/Discontinued
Tools Required:
- Distance acuity charts (e.g., HOTV, Sloan Letters, LEA Symbols) for 10 or 20 feet distances
- Near visual acuity cards appropriate for the child’s developmental level
- Random Dot E (RDE) stereopsis test for binocular vision
- Occluders: Lollipop occluders, glasses, or adhesive patches are preferred
Important Notes on Tools:
- Charts and tests must be age-appropriate and developmentally suitable.
- Non-standard occluders (hands, cups, tissues) are not permitted.
- Color vision screening is not required but may be recommended to provide additional information.