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Improving vision screening for children

The Vision 20/20 Project is a peer-to-peer vision screening programme. It’s a collaborative effort involving occupational therapists and product designers from Otago Polytechnic, optometrists from Otago University’s School of Medicine and staff and pupils at Tahuna Normal Intermediate School in Dunedin. The team hopes the Vision 20/20 Project will ultimately benefit children and their learning throughout Aotearoa. Their work is funded by the New Zealand Government’s Participatory Science Platform (PSP) – a world-first initiative that aims to engage communities in research projects that are locally relevant and have quality science and learning outcomes.

Female student doing eye test as part of Vision 20/20 Project

Being eye tested

Year 7 student Imogen shows the direction of the tumbling E as she is being eye tested as part of the Vision 20/20 Project.

Photograph by Grant Philips.

Rights: Tahuna Normal Intermediate School

Vision testing in New Zealand

Sometimes students’ eyesight is not as good as it could be. At present, there are two national opportunities for vision screening for children. The first is at the age of 4 when children are screened for amblyopia (lazy eye), but other conditions that might affect their capacity to read, such as long-sightedness and short-sightedness, and eye co-ordination are not tested. At age 11, students are again tested but only for distance vision. After both tests, it is up to parents to take action if follow-up care is required.

Myopia simulation

Myopia is an eye condition in which the eyeball is too long. This causes light rays to bend incorrectly and focus images in front of the retina instead of behind it. People with myopia find it is easier to see things close up, while objects that are further away look fuzzy or blurry. 

Corrective lenses take care of this issue.

Rights: The University of Waikato Te Whare Wānanga o Waikato

The gaps in the screening programmes led Mary Butler, Professor of Occupational Therapy at Otago Polytechnic, to think about social innovation as a way of reducing the effects of visual impairment on learning. Mary and her students created a prototype called the child-to-child vision screening toolkit.

I want to create awareness of the need for vision screening in children. As we have unpacked this, we have realised the issue is huge. It gets harder and harder for children with untreated low vision as they go through the education system as more and more reading is required.

Mary Butler, Vision 20/20 Project lead

How the child-to-child vision screening toolkit works

The toolkit has four tests for students to complete – high-contrast vision tests for each eye and low-contrast vision tests for each eye. It uses a ‘tumbling E’ acuity test, which means the person being tested simply has to point to the direction the limbs of the E are facing – up, down, left or right. The tumbling E also shows how the eye is behaving when it is reading key information.

Child to child vision screening: Roles

Child-to-child vision testing requires students to work in groups of three and take turns being the tester, the recorder and the testee.

In this extract from the Vision 20/20 Project demonstration video , Occupational Therapist Sarah Drummond and students from Tahuna Normal Intermediate School demonstrate the three roles.

Please note – the flip charts and recording sheets in this video are from an earlier version used by the project. Feedback and further development within the project, resulted in an updated flip chart and recording sheet that enables more data to be collected. The process of collecting data remains the same.

Rights: Vision 20/20 Project

The students work in groups of three and take turns being the tester, the recorder and the testee. The tester stands 4 m from the testee, holds up a chart and reads out the instructions for each test. The recorder watches the responses of the person being tested and uses a tick sheet that corresponds to the testing chart. The pages of the chart and the record sheets are colour coded to ensure the tester and recorder are using the same charts.

Students from Tahuna Normal Intermediate School have been working with the research team to find out what works and what needs to be tweaked.

We believe that, by designing in a collaborative and iterative way, this takes the guesswork away. We’re developing a toolkit that is truly user friendly, educational, visually appealing and is scientifically valid.

Machicko Niimi, product designer

The students have provided considerable feedback. In early iterations of the test, they found people being tested could simply memorise the letter patterns, which were repeated from test to test, so the team switched to the tumbling E design. Students suggested other modifications to the testing chart, including colour coding and the amount of text the tester had to read. They noted working in groups of three was easier and more effective than working in pairs. The students appreciate how their suggestions have been incorporated.

Peer to peer vision testing

Vision 20/20 is a collaborative project involving occupational therapists at the University of Adelaide and Otago Polytechnic, product designers from Otago Polytechnic, optometrists from Otago University’s School of Medicine and staff and pupils at Tahuna Normal Intermediate School in Dunedin. 

This video was produced by students at Tahuna Normal intermediate school to show others how to carry out peer-to-peer vision testing. The students were part of the team that trialled and refined the process as part of the Participatory Science Platform (PSP) Vision 20/20 Project. 

Additional supporting resources have been developed to bring the peer-to-peer vision testing into an in-depth teaching and learning program. 

Rights: Tahuna Normal Intermediate School

More than just an eye test

The Vision 20/20 Project provides an authentic context for learning. Two of the components – looking at the eye and eye health and using simulations that demonstrate how certain eye conditions can affect vision – align with the health and physical education curriculum. Working through the eye test helps students develop their science capabilities in gathering and interpreting data and using evidence. Vision 20/20 also hopes to create a supportive environment that enables students to get the help they need and to reduce any stigma about wearing eyeglasses.

The project team have created classroom resources:

The following resources are designed to be used alongside the Vision Health Module:

If you are interested in this project and would like a flip chart please email us.

Related content

Curious to know more about human vision? These resources will help.

You can hear teacher Karen Parker share her insights on the Vision 20/20 project in this recorded webinar.

Related activities

Use the Labelling the eye activity to learn about and identify parts of the human eye.

The activity Eye dissection uses cows’ eyes – they are a good size for observing many of the parts found in the human eye.

In the activity Pinhole cameras and eyes, students make a pinhole camera and see images formed on an internal screen. They then use a lens and see brighter and sharper images. This models the human eye and can be modified to demonstrate short-sightedness and long-sightedness.

Useful links

See these videos for additional information about the Vision 20/20 project.

Funding

The Vision 20/20 Project received funding through Otago Science into Action, the Otago pilot of the Participatory Science Platform (PSP) – a programme that is part of the Curious Minds initiative and funded by the Ministry of Business, Innovation and Employment.

The government’s national strategic plan for Science in Society, A Nation of Curious Minds – He Whenua Hihiri i te Mahara, is a government initiative jointly led by the Ministry of Business, Innovation and Employment, the Ministry of Education and the Office of the Prime Minister’s Chief Science Advisor

Logos of the Vision 20/20 Project stakeholders.

Vision 20/20 stakeholders

The Vision 20/20 Project has been supported and funded by a number of organisations.

Rights: Logos copyright of each organisation, school or project.

Published: 17 December 2020,Updated: 19 October 2021