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North Carolina mandates comprehensive eye exams for children
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In a groundbreaking legislative development, North Carolina has passed legislation requiring eye exams for all children entering kindergarten in the 2006 school year. North Carolina now joins Kentucky as a pioneer in the children’s vision legislation effort.
“In my opinion, all of the children in North Carolina will be better served once such a program envisioned in this legislation is in place,” said John D. Robinson, OD, executive director of the North Carolina State Board of Examiners, in an interview with Primary Care Optometry News.
Senate Bill 622
Senate Bill 622 was included as part of North Carolina’s budget bill and will become effective in the 2006-2007 school year. Section 130A-440.1 of the bill states that “every child entering kindergarten in the public schools shall obtain a comprehensive eye examination pursuant to the terms of this section not more than 6 months prior to the date of school entry.”
The bill goes on to specify that this comprehensive eye exam must be administered by a licensed optometrist or ophthalmologist in the state. A document confirming the completion of the comprehensive eye exam must be presented to the school principal prior to the start of school. Those children who have moved to North Carolina within 60 days of the start of the school year will have 60 days from the date of school entry to submit the comprehensive eye exam transmittal form.
The bill defines a comprehensive eye examination as consisting of the following visual tests:
- visual acuity at distance and near;
- alignment and ocular motility;
- binocular fusion abnormalities, including tracking;
- actual refractive errors, including verification by subject means;
- any color vision disorder;
- intraocular pressure as may be medically appropriate;
- ocular health including internal and external assessment.
Governor’s Vision Care Program
Included in the legislation is the Governor’s Vision Care Program, which supplies funds for the reimbursement of services for any child not covered by private insurance, NC Health Choice, Medicaid, the Department of Health and Human Services’ Commission for the Blind programs, Vision Service Plan’s Sight for Students program or the Lions Club Foundation. The Governor’s Vision Care Program also reimburses for any necessary spectacles for these children.
“On behalf of the entire optometric profession in North Carolina, we pledge the best efforts of our membership, in cooperation with other interested parties, to ensure that no child, regardless of circumstance, is left behind due to a lack of adequate vision care,” said R. Max Raynor Jr., OD, president-elect of the North Carolina Optometric Society, in a prepared statement.
Dr. Raynor stated that the legislation was enacted partially in response to recent studies, including the National Institute of Health’s Vision in Preschoolers (VIP) study. “As North Carolinians, we are proud to be among the first states to implement the recommendations resulting from recent studies and research by the National Institutes of Health as described in a recent release by the NIH,” Dr. Raynor said.
Ohio special education bill
A similar bill that was recently passed in Ohio requires a comprehensive eye exam for children referred into special education programs.
Amended Substitute House Bill 95 mandates that all children referred into Individual Education Programs (IEPs) receive a comprehensive eye exam, according to Richard Cornett, executive director of the Ohio Optometric Association.
Mr. Cornett told Primary Care Optometry News that the bill was originally introduced into the budget as a no-cost item by Sen. Randy Gardner, a previous teacher with a particular interest in vision issues.
“Mr. Gardner suggested doing this as a pilot project, so we worked through it, and 2 years ago, we put it in the budget as a no-cost item. It passed on a temporary basis,” he said. “The data have been coming in now for more than a year, so he decided to try to make it a permanent part of the state code.”
Mr. Cornett discussed the troublesome statistics regarding special education students and vision problems. “In a given year, 15,000 new students are referred for IEPs,” he said. “And it’s estimated that 60% of children in special education have a vision-related problem. We’ve been finding that many of these children have been suffering through undetected vision problems.”
This raises a difficult – if not unanswerable — question, Mr. Cornett said. “The question is, if the vision problem had been detected, would special education have been necessary?” he asked. “We obviously don’t have that answer.”
Mr. Cornett said, under the new law, any student referred into a special education program must have a comprehensive eye exam within 90 days. If it can be documented that the child has had one in recent months prior to being referred into the IEP, the requirement is waived.
According to Ohio Optometric Association president William G. Lay, OD, optometry took special provisions to ensure that no financial burden would be placed on Ohio schools.
“We had to be careful of the language because of the budget; we didn’t want to put any fiscal burden on the schools,” Dr. Lay told Primary Care Optometry News. “So in testimony, we said that through the different sources that are out there and the goodwill of the optometric community, we will make sure that all children, regardless of payment ability, receive an eye exam if referred into this program.”
For Your Information:
- John D. Robinson, OD, is executive director of the North Carolina State Board of Examiners in Optometry. He can be reached at 109 North Graham St., Wallace, NC 28466; (910) 285-3160 or (800) 426-4457; fax: (910) 285-4546; e-mail: exdir@ncoptometry.org.
- R. Max Raynor Jr., OD, is president-elect of the North Carolina Optometric Association. He can be reached at PO Box 220, Roseboro, NC 28382; (910) 525-5296; fax: (910) 525-5285.
- Richard Cornett is executive director of the Ohio Optometric Association. He can be reached at PO Box 636, Worthington, OH 43085; (614) 781-0708; fax: (614) 781-6521; e-mail: rcornett@ooa.org.
- William G. Lay, OD, is president of the Ohio Optometric Association. He can be reached at 185 S. State St., Westerville, OH 43081; (614) 898-9989; fax: (614) 898-3034.