Publications by authors named "Geoffrey E Bradford"

Concussion is a common injury in childhood and has the potential for substantial impact on quality of life. Visual issues have been increasingly recognized as a common problem after concussion. Many children initially seek care for concussion with their pediatrician, making it even more important for pediatricians to recognize, evaluate, and refer children with visual issues after concussion.

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Visual symptoms are common after concussion in children and adolescents, making it essential for clinicians to understand how to screen, identify, and initiate clinical management of visual symptoms in pediatric patients after this common childhood injury. Although most children and adolescents with visual symptoms after concussion will recover on their own by 4 weeks, for a subset who do not have spontaneous recovery, referral to a specialist with experience in comprehensive concussion management (eg, sports medicine, neurology, neuropsychology, physiatry, ophthalmology, otorhinolaryngology) for additional assessment and treatment may be necessary. A vision-specific history and a thorough visual system examination are warranted, including an assessment of visual acuity, ocular alignment in all positions of gaze, smooth pursuit (visual tracking of a moving object), saccades (visual fixation shifting between stationary targets), vestibulo-ocular reflex (maintaining image focus during movement), near point of convergence (focusing with both eyes at near and accommodation (focusing with one eye at near because any of these functions may be disturbed after concussion.

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Background: As instrument-based pediatric vision screening technology has evolved, the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) has developed uniform guidelines (2003, updated 2013) to inform the development of devices that can detect specified target levels of amblyopia risk factors (ARFs) and visually significant refractive error. Clinical experience with the established guidelines has revealed an apparent high level of over-referral for non-amblyopic, symmetric astigmatism, prompting the current revision.

Methods: The revised guidelines reflect the expert consensus of the AAPOS Vision Screening and Research Committees.

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Strong school-based vision and eye health systems include 12 key components to be implemented before, during, and after the actual vision screening event. The National Center for Children's Vision and Eye Health (NCCVEH) at Prevent Blindness partnered with the National Association of School Nurses (NASN) to provide guidance for school nurses for each of the 12 key components via a Vision and Eye Health webpage on the NASN website ( https://www.nasn.

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Successful vision screening efforts require the implementation of 12 key components of a strong vision health system of care. The National Center for Children's Vision and Eye Health (NCCVEH) at Prevent Blindness partnered with the National Association of School Nurses (NASN) to provide guidance around these 12 components via a Vision and Eye Health webpage on the NASN website ( https://www.nasn.

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The National Center for Children's Vision and Eye Health (NCCVEH) at Prevent Blindness partnered with the National Association of School Nurses (NASN) to provide guidance for school nurses responsible for screening the vision of preschool and K-12 students. Goals of this national partnership are to (1) standardize approaches to vision health, (2) facilitate follow up to eye care for students who do not pass vision screening, (3) provide family/caregiver friendly educational information, and (4) consult with leading pediatric eye care experts to promote evidence-based best practices. The NCCVEH/NASN partnership created a Vision and Eye Health page on the NASN website ( https://www.

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Current evidence-based and best-practice vision screening and eye health approaches, tools, and procedures are the result of revised national guidelines in the past 3 years and advances in research during the past 18 years. To help the busy school nurse with little time to keep up with changes in children's vision practices and a growing body of literature, the National Center for Children's Vision and Eye Health at Prevent Blindness is providing answers to seven questions that are often received from the field. Topical areas are (1) instrument-based screening and stereopsis, (2) optotype-based screening if child is referred from instrument-based screening, (3) next steps if a student's glasses are scratched or broken, (4) critical line screening with a threshold eye chart, (5) full threshold screening if student does not pass critical line screening, (6) holding a ruler beneath line of optotypes to identify, and (7) convergence insufficiency screening in the school setting.

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Current evidence-based and best practice vision screening and eye health approaches, tools, and procedures are the result of revised national guidelines in the past 3 years and advances in research during the past 18 years. To help the busy school nurse with little time to keep up with changes in children's vision practices and a growing body of literature, the National Center for Children's Vision and Eye Health at Prevent Blindness is providing answers to five questions that are often received from the field. Topical areas are: (1) instrument-based screening for children ages 6 years and older, (2) stereoacuity screening and Random Dot E, (3) binocular distance visual acuity screening, (4) a 2-line difference between the eyes as part of referral criteria, and (5) state vision screening guidelines excluding evidence-based tools.

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Current evidence-based and best practice vision screening and eye health approaches, tools, and procedures are the result of revised national guidelines in the last 3 years and advances in research during the past 18 years. To help the busy school nurse, with little time to keep up with changes in children's vision practices and a growing body of literature, the National Center for Children's Vision and Eye Health at Prevent Blindness is providing answers to five questions that are often received from the field. Topical areas include (1) which numbers to record when using a 10-foot chart, (2) instrument-based screening and visual acuity, (3) screening children who wear glasses, (4) referring children who do not pass color vision deficiency screening, and (5) conducting near visual acuity screening monocularly or binocularly.

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Current evidence-based and best-practice vision screening and eye health approaches, tools, and procedures are the result of revised national guidelines in the past 3 years and advances in research during the past 18 years. In providing answers to the five questions in this article, the National Center for Children's Vision and Eye Health at Prevent Blindness used published, peer-reviewed research; vision screening and eye health national guidelines; and consensus-based best practices from eye care professionals and public health experts. The answers may differ from your state or district vision screening guidelines and mandates.

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Current evidence-based and best practice vision screening and eye health approaches, tools, and procedures are the result of revised national guidelines in the past 3 years and advances in research during the last 16 years. To help the busy school nurse with little time to keep up with changes in children's vision practices and a growing body of literature, the National Center for Children's Vision and Eye Health at Prevent Blindness is providing answers to 20 questions received most often from the field. Question topics are: (1) arranging the screening environment, (2) occluders to cover the eyes during vision screening, (3) optotype-based screening at distance, (4) optotype-based screening at near, (5) instrument-based screening, (6) muscle imbalance screening, (7) referrals, and (8) vision screening certification.

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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.

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Purpose Of Review: There has been a surge in legislative activity concerning children's vision in recent years. This review will summarize and compare newly enacted state statutes and review legislation that has been introduced at both the state and federal level. Detailed reference sites are provided and may be a useful resource for those involved in legislative advocacy.

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Objectives: Visual disorders among preschool-aged children are common, yet screening is infrequent. The purpose of this project was to implement the vision screening recommendations proposed by the Maternal and Child Health Bureau and National Eye Institute Vision Screening in the Preschool Child Task Force: monocular visual acuity and stereopsis testing.

Methods: Four sites fully participated in the implementation of the task force recommendations with 3- and 4-year-old children.

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