# Current Challenges Supporting School-Aged Children with Vision Problems: A Rapid Review
###### Abstract  
Many children have undetected vision problems or insufficient visual information processing that may be a factor in lower academic outcomes. The aim of this paper is to contribute to a better understanding of the importance of vision screening for school-aged children, and to investigate the possibilities of how eye-tracking (ET) technologies can support this. While there are indications that these technologies can support vision screening, a broad understanding of how to apply them and by whom, and if it is possible to utilize them at schools, is lacking. We review interdisciplinary research on performing vision investigations, and discuss current challenges for technology support. The focus is on exploring the possibilities of ET technologies to better support screening and handling of vision disorders, especially by non-vision experts. The data cognate from a literature survey of peer-reviewed journals and conference articles complemented by secondary sources, following a rapid review methodology. We highlight current trends in supportive technologies for vision screening, and identify the involved stakeholders and the research studies that discuss how to develop more supportive ET technologies for vision screening and training by non-experts. school children; functional vision; vision screening; vision training; eye-tracking stakeholders +
Footnote †: journal: Medical  
they have the same symptoms, but need to be treated separately [5; 8; 9]. The early detection of vision disorders is also important for minimizing upcoming problems associated with academic performance and social life [10; 11; 12]. Vision screening is compulsory in many European countries, and is generally performed on children prior to the commencement of school education at the age of 4-5 years [13]. After this age, the parent or legally responsible person has to follow up on their child's vision health. Since children's vision continues to develop, it may change and they may experience difficulties, especially when they begin at school [6; 14; 15]. Teachers or parents can detect and help the problems, but the most important stakeholders for screening and helping with treatments are the responsible vision specialists from healthcare institutions. Visual functional assessments (e.g., visual acuity, color vision testing, and contrast sensitivity) can fail to diagnose the possible functional problems of the vision system [16]. These not only relate to reading difficulties, but have other symptoms, such as deficient attention span, fatigue, headache, dizziness, poor academic performance, and productivity [17; 18; 19]. A child with some of these problems can often control eye movements for a few minutes before experiencing difficulties. Therefore, during typical tasks with vision screenings--which often have a short duration--these problems may not be identified [20]. Some of these problems can be due to various concrete functional problems of the vision system, and are alleviated through vision training [21; 22]. In recent years, promising options supporting necessary vision tests have begun to appear that use technologies and computerized tasks [20]. Several eye-tracking (ET) technologies can measure the movements of the left and right eye separately, and therefore ET technologies are promising for producing a measurement that can help to indicate functional vision problems [23]. ET technologies are often integrated with computer programs to make screening and training more flexible by incorporating serious games (SG), or utilizing virtual reality (VR) technologies to use the surrounding space [24]. However, it is difficult to keep track of and understand the role of these new solutions. The motivation behind this paper is to enhance the understanding of what technology development can contribute to screening the vision of school-aged children, especially for non-vision expert users. For this, one needs to know who can be involved in vision screening, their roles, competencies, and willingness.