During my freshman English class, I was sent with a dozen of my peers to the nurse’s office, where our vision was tested by a school nurse specialist. I hadn’t previously known about the testing. The screener instructed me to look into a camera-like box that instantly determined whether I needed glasses. After the evaluation, I asked what the box was doing. The screener responded that it took a picture of my eyes and used algorithms to check my vision. That seemed cool and futuristic, but I became more concerned the more I considered the proposition: an agent of the state had photographed my eyes without my parents’ consent or knowledge, and I had no idea what had become of those images.
Calvert County Public Schools (CCPS) and the Calvert County Health Department (CCHD) have used the Welch Allyn Spot Vision Screener to screen students’ vision for almost six years, since about 2017. The device functions by taking a picture of one’s eyes and using algorithms to instantly check for various vision issues. The equipment is marketed as being able to “automatically capture an image” that’s “easy to…share,” with its instructions detailing USB capabilities for exporting results and images. The examples they provide of the “results” that can be transferred and stored include pictures of the children’s eyes.
After CCHD representatives complete a day’s screening, the images of students’ eyes stored in the equipment are transferred onto a USB drive, then from the USB drive to a physical computer. Student information is connected to the images to allow the images to be shared with parents and healthcare professionals in the event that a student needs help.
High quality facial and eye scans can more accurately identify individuals than fingerprints and other traditional biometrics. Serious privacy issues are posed by the implications of their mass collection. In the extreme, this could perhaps allow the growth of a powerful surveillance state reminiscent of China, with its system of tracking citizens. While the images taken and saved by CCHD aren’t likely of high enough quality to pose much danger to students’ privacy, the precedent of a government entity taking such biometrics from minors, especially without clear parental notification and consent, is concerning.
Per the Annotated Code of Maryland Education Article § 7-404, the state of Maryland requires schools to screen students’ vision upon entering the public school system, during the first grade, and again in either the eighth or ninth grade. In Calvert County, these screenings are conducted by CCHD, except in the high schools, where screenings are conducted by school nurses. CCHD and other organizations who can afford them use the Spot Vision Screener because it’s more efficient and can evaluate various vision issues simultaneously, catching conditions that haven’t started affecting an individual’s vision.
Copies of the results are kept on file at the high school, but only include a pass/fail specification, not the files that include the images. Those files are retained by CCHD. According to Kristie Fox, who helps facilitate vision screenings conducted by CCHD, the images are stored on a physical computer at CCHD, not a cloud-based drive, so access requires physical connection. This makes the files more secure. Other legal and software measures are in place to protect student information. Fox wasn’t aware of plans to delete the records, saying, “The images are saved on the drive, so far, I have them for the past three years… Electronic records, to my knowledge, aren’t automatically deleted after a specific time period. There is no real benefit to keeping the records after the respective school year, I just haven’t deleted them from the drive.” When asked about these files, CCHD Deputy Health Officer Champ Thomaskutty said, “We don’t keep permanent records of the school screenings. The last three years have been, sort of – the intent is to have them purged every school year, that’s the base premise, but with how COVID interrupted the process we need to make sure that the school had time to do their follow-up.”
There are various methods through which schools can fulfill the Maryland state requirement to screen students’ vision. The June 2023 Vision Screening Guidelines from the Maryland State Department of Education and Maryland Department of Health lists at least three different types of vision screening processes for schools, each with its own idiosyncrasies that fit specific demographics. For example, one test uses symbols to screen pre-readers while another uses letters for those over the age of five. According to the guidelines, Spot Vision Screeners like those used in CCPS are recommended for ages 3-5 because they are quick and require minimal cooperation, saying, “Use at school system entry if age 5 years or below; may be considered in higher grades if unable to participate in optotype-based screening [eye charts].”
Before screening, parents are notified via email and in other school communications of upcoming testing, but only in very general terms. This notification is intended to allow parents the time to conduct their own screening or contact school officials if they wish the screening not take place. Said Thomaskutty, “The general framework is an announcement communication goes out – the school nurse or someone on behalf of the school nurse – sends out to parents prior to testing. It’s well in advance, so it gives parents the opportunity to either conduct their own, more formal eye examination and have that documentation or communicate that they wish to opt-out.” However, it wasn’t indicated in school communications that images of students’ eyes would be taken. It wasn’t indicated that those images would be saved, even just for a year. Permission was not sought.
As documented in a recent letter, parents were notified that their child’s vision and hearing were required to be screened unless similar tests had been performed by an optometrist or ophthalmologist in the last year. The letter didn’t mention the possibility to opt-out, as acknowledged by Thomaskutty, or the legal provisions that allow for parents to opt-out of vision screenings if they state in writing that such screenings violate the tenants of their espoused faith – it only used the word “required.” The actual situation appears to have been somewhat misrepresented in school communications. Furthermore, letters are often sent by email, along with the thousands of other emails parents receive. It’s not unlikely that many parents missed the email and had no idea anything had happened unless their child told them later.
Perhaps it should be the prerogative of the state of Maryland to screen students’ vision and hearing. These conditions certainly affect students’ ability to learn, and the policy is likely focused on helping those who otherwise wouldn’t receive the care they need. Some would argue that healthcare is never the school’s place, but many would consider it reasonable to perform these screenings. The new, time-saving technology is genuinely cool and intriguing. However, to parents, students, and school officials, “vision screening” does not equate to “taking and storing images of students’ eyes.”
There’s no evidence of nefarious intent behind CCHD’s system for screening students’ vision, but the precedent is somewhat concerning. In our modern world, the eyes have become another biometric with incredible identification capabilities. In this type of society, it’s reasonable to say that students, parents, and community members should know exactly what’s going on with school vision screenings. Parents should know that CCHD is taking and storing images of students’ eyes, not just that their child’s vision is being “screened.” Community members should know what measures are being taken to protect students’ privacy. The opt-out option should be more obvious in school communications, not eclipsed by the word, “required.” While the images taken and saved by CCHD aren’t likely of high enough quality to pose much danger to students’ privacy, the precedent of a government entity taking such biometrics from minors, especially without clear parental notification and consent, is concerning.
