A historical review of distance vision screening eye charts: what to toss, what to keep, and what to replace.

Vision screening protocol and equipment guidelines differ among schools across the United States. Budget cuts are forcing many school nurses to reevaluate their vision screening programs, as well as items in their vision screening toolboxes. School nurses tasked with inventorying those toolboxes to determine which items to toss, keep, or replace are oftentimes perplexed by the copious choices featured in vendor catalogs and websites. For school nurses who want their vision screening toolboxes to include eye charts, national and international eye chart design guidelines are available to help ensure selected eye charts are standardized. A national consensus policy exists that recommends specific eye charts. And, a large body of vision screening literature is available to help school nurses make informed decisions. Current documents suggest that LEA Symbols are appropriate for young children and Sloan Letters are a better choice than "Snellen" charts for older children.