During the 2020-21 academic year, COVID-19-related educational disruptions impacted school-based vision screenings. However, limited information regarding changes in vision screening and the number of students impacted has been reported. Delayed screenings can negatively impact students' referral to eye care providers, which may affect a child's ability to see clearly and academic success. This study aims to describe changes in school-based vision screening practices through a survey of National Association of School Nurses state representatives (n = 49). Among states with vision screenings mandates, participants reported that 23.7% (9/38) states waived screenings, 31.6% (12/38) continued screenings, and 36.8% (14/38) modified requirements, such as grades screened or assessments included (e.g., color vision and stereoacuity screenings). These results suggest that millions of students across the United States missed vision screenings during the 2020-21 academic year. Efforts by education and school health stakeholders should be directed towards addressing the pandemic-related disruption in vision screening.