By Kristan Gross
A child’s first academic experience is equal parts exciting, transformational and scary. Every fall, boys and girls walk through their schools’ doors for the first time with a new pair of shoes, supplies and backpack to boot. But are these new scholars really set up to succeed? If they’ve never received a comprehensive eye exam, it’s very likely that they aren’t. Experts note that 80 percent of what our children learn in school is through their eyes. Yet according to national averages, 25 percent of children suffer from an undiagnosed vision condition.
According the Centers for Disease Control, vision disabilities are among the most prevalent disabling conditions for children. In fact, undetected vision conditions do more than just limit a child’s ability to see. They limit his or her ability to learn, can lead to the misdiagnosis of a learning disability such as attention deficit hyperactivity disorder (ADHD) or attention deficit disorder (ADD), can increase the likelihood of becoming involved in the criminal justice system and in some instances, can even lead to blindness if not identified and treated early.
The statistics tell the story. Children with uncorrected vision:
• Are often misdiagnosed as having a learning disability. Some 40 percent of children with diagnosed learning disabilities have vision issues.
• May suffer from permanent vision loss if a vision issue such as amblyopia, better known as lazy eye, is not treated by age seven.
• Could face legal troubles. One study suggests 70 percent of juvenile offenders have been found to have uncorrected vision problems.
• Could earn up to 12 percent less income over their lifetime.
Vision impairments don’t just affect school-age children. The medical journal JAMA Ophthalmology published findings that 175,000 preschoolers in the United States struggle to see because of untreated vision problems, and the report expects this number will increase to 26 percent of children by 2060.
States take action
Recognizing the critical importance of eye exams and vision health, some states, including Illinois and Kentucky, have taken charge and made comprehensive eye exams mandatory for children before they enter their first academic experience.
In 2000, Kentucky passed a law that mandated vision examinations for all children who enter kindergarten. The state has seen marked improvement in test scores since this law was enacted. On top of that, the program has caused no financial burden to the state. In fact, during its first year, only 0.1 percent of the $150,000 budget that was set aside for this program actually was used.
A study conducted by the Illinois Eye Institute and Chicago Public Schools (CPS) after Illinois passed similar legislation in 2007, showed a statistically significant improvement in GPAs and math test scores after students received comprehensive eye exams and glasses. The study included an assessment of 14,663 CPS students who received comprehensive eye exams between January 2011 and January 2014. It found that 15 percent of the students were suffering from moderate to severe uncorrected refractive error—conditions that may have gone undiagnosed without this legislation and ones that are easily corrected with glasses.
Following their eye exams, those 15 percent of patients showed significantly higher GPAs and greater improvements on test scores than their student counterparts without vision problems. The study also found that students who received their eye exams during third or fourth grade experienced greater gains in math test scores than students who received eye exams during Grades 5 through 7. These findings continue to prove that early intervention is key.
Vision care and the Affordable Care Act
What many educators and parents don’t know is that today the majority of children under the age of 19 have access to a comprehensive eye exam through one of several options such as the current Affordable Care Act, Medicaid, private insurance or other philanthropic organizations that help to fill the gap.
The future of essential health benefits such as vision care for children is at risk, as the future of the Affordable Care Act is uncertain. Currently, more than 100 organizations, including the Vision Impact Institute, are advocating that children’s vision coverage be maintained in any new health care legislation through some form of essential benefits.
If these benefits were to go away, it will be incumbent upon individual states, such as New Jersey, to ensure that children have affordable access to this essential care.
What parents and educators need to know
While nearly every child in New Jersey has access to affordable eye care, many parents aren’t aware that these benefits are available or that their child needs to have an annual exam. Often, if parents don’t wear glasses, getting an eye exam isn’t on their radar. To ensure that all children receive comprehensive eye care, the American Optometric Association has put out recommendations on how to ensure your child’s vision is healthy: children should get their first eye exam at six months, another at three years old, and an exam before entering school and every two years after that.
There is also the misconception that a vision screening is sufficient. Offered in our schools and by pediatricians, screenings help to identify farsightedness, which is whether a child can see faraway objects. Yet screenings typically are not administered by someone who specializes in eye health—such as an optometrist or ophthalmologist—and the test does not check for other critical visual issues such as whether or not a child’s eyes work properly together.
A comprehensive eye exam is the only way to diagnose all potential vision issues, including nearsightedness, lazy eye, crossed-eyes and eye coordination. The exam can also identify major health issues such as pre-diabetes, high cholesterol, and hypertension.
Unfortunately, many children who fail an in-school vision screening do not receive the proper follow-up care. Often, this is because parents either neglect to take their children for a comprehensive exam or are unaware that their child has failed the screening and has a potential vision issue. An estimated 48 percent of parents with children under the age of 12 have never even taken their children to an eye care professional.
Some schools in New Jersey are taking their screening programs a step further. Newark Public Schools, for example, recently announced a partnership with the Helen Keller International ChildSight program and Vision to Learn to provide screenings, free eye exams for students who fail their screening and free glasses, if needed, to its 25,000 students in grades K-8.
Programs such as these are a good step forward. Nonetheless, they would be even more beneficial if they reached the gold standard as defined in the 2016 report by the National Academies of Sciences, Engineering and Medicine: children need to receive a comprehensive eye exam prior to entering kindergarten. This gold standard would ensure each and every kindergartner in the school district would start his or her academic career on a level playing field when it comes to vision.
A comprehensive eye exam administered by an optometrist or ophthalmologist should be added to every parent’s pre-kindergarten health screening checklist, similar to any MMR or immunization requirement. Getting this testing done early in a child’s life ensures that the child’s eyes are healthy and working together. It also establishes a baseline by which to measure eye health throughout childhood.
What educators can do
Until comprehensive eye exams become a standard requirement for entering school, what can educators do?
First, they can educate their students’ parents on why it’s important to take their child to see an eye doctor, reminding them of the impact vision health has on academic success. Second, they can look for warning signs that a child might be struggling to see. For example, if a child is squinting to see the white board, complains of headaches, struggles to read, or is constantly rubbing his or her eyes, it might be time to suggest a visit to the eye doctor.
If an educator is informed that a student has failed a vision screening, the teacher should reach out and talk to the parent to ensure the parent is aware of the issue and discuss how a comprehensive exam can benefit his or her child. If a teacher believes that a parent may be worried about cost, he or she can recommend programs such as the Optical Academy (see Page 29) that often provide free or inexpensive exams to those who cannot afford them.
The simple fact is that for one hour of a parent’s time, a lifelong impact can be made on a child by simply taking him or her to get a comprehensive eye exam. Armed with this eye exam, children will be more likely to participate in class, concentrate and complete their academic assignments and socialize with their fellow classmates and friends.
Kristan Gross is the Global Executive Director of the Vision Impact Institute and is part of the Kids See: Success Initiative. In March 2017, she testified before the New Jersey Legislature’s Joint Committee on the Public Schools about the impact of poor access to vision care for students. She can be reached at firstname.lastname@example.org. You can learn more about the Vision Impact Institute at visionimpactinstitute.org.
As reported in the main article, many children who fail an in-school vision screening do not receive the proper follow-up care. An estimated 48 percent of parents with children under the age of 12 have never even taken their child to an eye care professional. And many parents do not believe that they can afford the expense of an eye exam and corrective lenses for their children.
Your local or county association can help these children and families by hosting Optical Academy. If you can arrange for a location, such as an all-purpose room, cafeteria, gym, library, or community facility that can be used to house an Optical Academy on-site visit your association can offer a solution to the issues addressed in the article.
Optical Academy’s vision team of mobile eye care professionals consists of optometrists, opticians and assistants. They conduct comprehensive eye exams for students and staff in the comfort of your own school, worksite or community center through the use of advanced digital mobile equipment.
For every 50 paid appointments, Optical Academy offers 10 free exams to students whose families are uninsured or cannot afford an exam and corrective eyewear. The school nurse is often a good resource for determining which students may need this benefit. Generally, Optical Academy requires at least 50 scheduled paying clients before confirming the on-site visit.
An ideal location allows for:
• A series of dates that can be scheduled well in advance and posted on the Optical Academy website.
• A minimum of eight hours of operation each day.
• Scheduling of appointments throughout each day.
• Permission for neighboring associations, schools, or communities to be invited, if practical.
• Parking and ease of access.
Optical Academy will work with you and your school district to set up screenings at no cost to your local education association or the district. To set up an Optical Academy screening for your community, contact at Events Coordinator Jessica Molina at 973-298-1400, Ext. 3007, or Jessica@optical-academy.com. You may also email Stev Padilla at Stev@optical-academy.com.