Massachusetts State
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Summary of the Massachusetts State Guidelines
1. Required Screenings
- Preschoolers (ages 3–5): Annual vision screening starting at school entry.
- Kindergarten through Grade 5: Vision screening annually up to age 11.
- Grades 6–8: One screening between ages 12–14.
- Grades 9–12: One screening between ages 15–18.
- New Students: Screened for distance, near visual acuity, and stereopsis if prior screening evidence is unavailable.
- Prior to Kindergarten Entry: Screening or eye exam results from the previous 12 months must be submitted by parents.
2. Screening Referral Criteria (Criteria for Passing Vision Test)
Distance Visual Acuity:
- Preschool (3 years): Pass at 20/50.
- Preschool (4+ years): Pass at 20/40.
- Kindergarten through Grade 12: Pass at 20/32.
Near Visual Acuity:
- Required for ages 3 through 9 (up to Grade 3); pass at 20/32.
Stereoacuity:
- Pass 1 Smile Test used for children ages 5–9 (Grades K–3).
Instrument-Based Screening:
- For ages 3–5: Instrument screening (e.g., Spot™, PlusOptix) replaces other visual acuity screening but requires near acuity test.
- Failing Criteria: Any student not meeting these thresholds requires referral for a comprehensive eye exam Massachusetts.
3. Children Who Should Bypass Screening
- Neurodevelopmental Delays: Must present proof of an eye exam.
- Complex Disabilities: If unable to complete or benefit from standard screenings.
- Children Already Under Eye Care: Those with recent eye exams or diagnosed eye conditions.
- Children Exhibiting Vision Concerns: Signs from teachers, nurses, or parents may prompt a direct referral without screening.
4. Required Tools OR Important Changes to Tools Used/Discontinued
Approved Tools:
- Distance charts: LEA SYMBOLS® or Sloan Letters with logMAR notation.
- Near vision charts: LEA SYMBOLS® with 16-inch cord.
- Stereoacuity: Pass 1 Smile Test for ages 5–9.
- Instrument-based screeners for ages 3–5: Spot™, PlusOptix, Retinomax.
Discontinued Tools:
- Random Dot E for stereoacuity.
- Visual Acuity Machines (e.g., Optec, Titmus, Keystone View) are no longer recommended due to reliability concerns.