Research shows children would benefit from comprehensive eye exams

Aug 19, 2009
By: Ophthalmology Times Staff Reports
Ophthalmology Times E-News

Washington-A new report from the National Commission on Vision and Health concludes that even though universal comprehensive eye exams for children conducted prior to starting school would result in more vision problems and eye diseases being diagnosed and treated successfully in children, requirements vary widely from state to state, and only three states require eye examinations for school-aged children, according to a prepared statement.

The report, "Building a Comprehensive Child Vision Care System," found that children are being screened at low rates, and those who are screened often do not receive the follow-up and treatment they may need. Children without health insurance and those living in poverty are at the greatest risk.

Although the majority of states require some type of vision screening prior to children entering public schools, they often fail to use the best screening tests and to ensure important follow-up for those in whom problems are identified, according to the release. Kentucky, Illinois, and Missouri are the only states that require comprehensive eye exams for children entering school, and 15 states currently do not require any form of screenings or exams.

"Children from low-income families lack the health-care resources necessary to break the cycle of poverty," said David Rosenstein, DMS, MPH, Oregon Health & Science University professor emeritus, Portland. "This lack of vision care is handicapping our most vulnerable populations. Research from the Centers for Disease Control and Prevention shows that 83% of families earning less than 200% of the federal poverty level have children who have not seen an eye-care provider during the prior year. This must change now for the sake of our children."

Deborah Klein Walker, EdD, principal author of the report and past president of the American Public Health Association, said: "This report finds that vision screenings are not the most effective way to determine vision problems. Screenings missed finding vision conditions in one-third of children with a vision problem, and most of the children who are screened and fail the screening don't receive the follow-up care they need. This, despite the fact that many of the vision problems affecting children can be managed or even eliminated if they receive proper care right away."

Studies indicate that one in four children has an undetected vision problem. In addition, a quarter of school-aged children have vision problems that could have been addressed or eliminated if appropriate eye-assessment programs and follow-up care had been in place when they started school, according to the statement.

The commission recommends that agencies at the federal, state, and local levels work with academia, businesses, providers, and the public to create a comprehensive child eye-care system to ensure that all children are assessed for potential eye and vision problems before entering school and throughout the school years, according to the release. The commission also recommends a point of accountability within local public health agencies, a national education campaign, and ongoing data collection to monitor the use and efficacy of child vision exams.