Spotting Myopia in the Classroom is Trickier With Today’s Near Work Emphasis

Share

Tweet

Share

Share

Email

November 17, 2025

By Katherine Schuetz, OD

In the past, our practice would often get referrals during the school year that started with a teacher noticing a child squinting at the board. However, today’s emphasis on near work—whether reading, screen time, online learning or gaming—means fewer children show those traditional symptoms. Waiting for blurry vision complaints would let too many young eyes slip through the cracks. So, rather than wait for them to come to me, I reached out to my Carmel, Indiana, community.

We cannot wait for parents to be proactive about myopia management, because they are unfamiliar with the condition. So I set out to get their attention. I channeled my outreach toward pediatricians and school nurses, knowing they would make the strongest referral engines. Armed with eyeglass repair kits and contact lens solution, I visited every school nurse in my district, introducing myself as the local pediatric optometrist and offering free vision testing—not acuity testing–in the schools for students. I made it clear that my goal wasn’t to sell glasses but to raise eye health awareness and detect myopia as early as possible.

The outreach proved pivotal. Today, with a team of four doctors and five support staff, our program reaches more than 20 schools across Carmel.

A MINI CLINIC 

At these visits, we test retinoscopy, ophthalmoscopy and cover tests. I replace the generic pass/fail report for parents with precise feedback: which eye or eyes are nearsighted or farsighted and what degree of concern that finding represents. A generic pass/fail report rarely spurs follow-through. Parents need the why.

Efficiency is essential. Thanks to years of refining our workflow and help from nurses and teachers, we’ve streamlined our process. We arrive at schools before the first bell and transform a spare classroom or office into a mini clinic. Having discovered on my first ever visit that acuity testing is too time-consuming and yields too many false positives, we now solely test objective measures. With this process in place, we zip through around 100 students in an hour, sacrificing hardly any chair time at Little Eyes. 

This process has helped us build deep trust with our school nurses. They know they can call at any time about playground injuries, red eye concerns or sudden vision changes. That trust extends to families, too. Since starting this initiative in 2013, we’ve had more families scheduling exams directly in the practice.

MYOPIA MANAGEMENT AT LITTLE EYES

In the clinic, we offer low-dose atropine, orthokeratology and soft multifocal contact lenses. Many parents ask me the same question: Which is the best? I explain that there’s no one “best” option—what matters most is matching the therapy to their child’s age, maturity, needs and lifestyle choices.

To show families the real impact of our interventions, we use our IOL Master to show any changes in axial length measurement. I’ve used this device for years, and it’s my favorite piece of data to share with parents. Watching the progression curve begin to flatten after initiating treatment delivers a powerful visual confirmation that our parent-doctor collaboration is working. These data-driven discussions strengthen families’ commitment and support long-term adherence. 

Giving Back to the Community

Beyond exams and classroom screenings, I channel my community spirit into programs that give back. Through our Double Vision program, every in-office glasses purchase generates a donation to the Indiana Blind Children’s Foundation. We also partner with the Carmel Lions Club to redistribute donated eyeglasses to community members in need.

Putting these steps together has turned Little Eyes Pediatric Care into a trusted community partner and resource. As modern classrooms blur the old warning signs and children devote even more hours to near work, it’s more important than ever to be proactive in identifying and addressing childhood myopia. I encourage fellow pediatric optometrists to partner with local schools, too—even just a few classroom screenings each year can make a real difference for students and amplify your practice. It’s a long game, but as I’ve learned, it truly pays off.

 

Katherine Schuetz, OD, is a private practitioner in Carmel, Indiana, where she is a full-time clinician, splitting time between seeing pediatric patients at a primary care pediatric practice, Little Eyes, and teens through adults at RevolutionEYES. She is a Brilliant Futures panelist for CooperVision.

 

Nurse Notes Importance of Annual Vision Checks Kady Weaver, BSN, RN, is a nurse at Carmel Elementary School, one of the schools where Dr. Katherine Schuetz or her team visits each year.  “As a parent of a child with vision difficulties that still affect her today, I am very vocal when advocating for additional screenings/care of children with suspected visual challenges. While I am not the first to notice issues with vision, I am the first contact a parent receives from school recommending further care. I don’t get as many referrals from classroom teachers as I did five years ago. I believe this is mainly due to not having as much work displayed on a whiteboard or projector screen as there was in the past.  “The main things I tell teachers to look for are squinting, holding reading materials too close and blinking excessively. If they do notice issues, I will do a screening in my office and refer out as needed. I realize that when we do find a concern, the main goal is not just to get glasses, but to access treatments that can actually slow the progression of myopia. As a school nurse, I work together with parents and educators to instill habits that can help protect kids’ vision.  “Unfortunately, there is not a lot of opportunity from the school health clinic to spread the word about vision screenings, but if a parent or teacher asks, I always recommend getting vision checked by a professional. Yearly vision checks are just as important as preventative annual physicals, as our eyes are the key to the world.

 

To learn more about collaborating with other health care professionals, check out our Getting Started with Myopia Management series here.