Screening, Assessment, and Evaluation

Ophthalmologists (MD/DO)

Medical and surgical eye doctors that provide complete

eye care including diagnosis, treatment, and surgery for eye conditions.

Optometrists (OD)

Primary vision care providers are often the first point of

contact for most vision needs. Not medical doctors, but highly trained in

primary eye health and disease management. Perform comprehensive eye exams,

vision tests, prescribe/dispense glasses/contacts, diagnose common eye

conditions, prescribe medications, and offer vision therapy.

Opticians

Eyewear specialists that work with prescriptions from ophthalmologists or optometrists.

Opticians do not diagnose or treat eye diseases. They typically fit and dispense

eyeglasses, contact lenses, and adjust frames.

Role of the Teacher of Students with Visual Impairment

The Teacher of Students with Visual Impairment (TVI) supports students, families, and school staff to meet the needs of learners with visual impairments. The TVI:

• Provides direct instruction, co-teaching, and models teaching strategies.
• Advises on adapting environments and materials.
• Trains and consults with school and community staff.
• Recommends ways for students to access the general curriculum and join school activities.
• Teaches skills like braille, assistive technology, visual efficiency, and social skills as needed.
• Supports families in helping young children reach milestones.
• Helps students build independence, self-esteem, and social acceptance in preparation for adult life.

Role of the Certified Orientation & Mobility Specialist

Certified Orientation & Mobility Specialists (COMS) teach students with visual impairments to move safely at school, home, and in the community. They:

• Teach mobility skills using canes, devices, and low-vision strategies.
• Create or adapt materials like tactile maps.
• Train and advise teachers and families to help children safely and independently travel.
• Help families support motor and sensory development.
• Provide practice in real places (stores, buses, streets).
• Attend IEP meetings and keep records.
• Help students gain independence and confidence at home, at school and in the community.

Vision screening is a helpful way to find vision issues early. Screenings can detect issues related to visual acuity, basic eye alignment, and color blindness. They should be done every year for children attending school-based preschool programs and are mandatory for school-aged children who must be screened in grades: Kindergarten, first, third, fifth, seventh, ninth and eleventh.

Remember, screenings are a good first step to spot possible vision problems, but they do not replace a full eye exam by a medical professional.

Comprehensive eye exams are done by optometrists or ophthalmologists. They use special instruments to get a complete view of a child’s eye health, vision, and visual skills. Some of the areas they check may include:

• Visual Acuity: Reading an eye chart to check sharpness or clarity.
• Refraction: Determining your exact glasses/contact lens prescription.
• Slit-Lamp Examination: Using a microscope to view the front of your eye.
• Tonometry: Measuring eye pressure for glaucoma screening.
• Ophthalmoscopy: Exams the retina, optic nerve, and blood vessels.
• Color Vision: Tests for color blindness.
• Visual Field Test: Checks peripheral vision for blind spots.
• Pupil Response: Assessing how pupils react to light.
• Eye Muscle Movement: Checking eye coordination.

Functional Vision Assessment or FVA

As part of the first evaluation, the Teacher of the Visually Impaired does a Functional Vision Assessment (FVA). This checks how a student uses vision in different places, both familiar and new. The FVA looks at things such as peripheral vision; how well the student sees color and contrast; sensitivity to light and preferred lighting; how the eyes move; and how well the student sees up close and far away. The FVA report offers team members suggestions for teaching and accommodations.

A Certified Orientation & Mobility Specialist (COMS) may also assess skills during the FVA about whether the student needs help with current or future mobility skills. The FVA should be done before other assessments so team members can consider vision-related factors when they do their tests.

Learning Media Assessment or LMA

The Learning Media Assessment (LMA) helps determine what specific visual, tactual, and/or auditory learning media are best for a learner. A TVI conducts this assessment. Once an LMA has been completed, and the team has made decisions about print and braille instruction, the IEP form Children With Visual Impairment has to be completed specifying one or more reading and writing media in which instruction is appropriate to meet their educational needs as part of the IEP process.

IEP goals are written based on the LMA results to support the student's best learning media. If braille is chosen, the student needs direct instruction from a TVI so they can learn braille skills. To help students reach their full literacy potential, teams should understand that braille literacy is just as important as print literacy. Students who use braille need the same level of reading and writing instruction as sighted students who use print.

Clinical Low Vision Evaluation or CLVE

Optometrists, ophthalmologists, and/or certified low vision therapists may conduct a CLVE. Recommendations can include using special devices, adjusting lighting, reducing glare, and using color contrast to make things easier to see.