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Preschool eye exams — in the children’s best interest
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A friend of ours who teaches first grade recently told me about one of her students who must wear glasses. Apparently, when this child wears his glasses he’s a model student – interested, attentive, participatory and cooperative. Yet, on those days where he’s misplaced or broken his glasses, he’s just the opposite. There’s no doubt in her – and my – mind that this youngster must see to learn.
I don’t believe this child’s experience is that unusual. In fact, I think most parents, educators, opticians, optometrists and ophthalmologists and pediatricians would agree. Vision is a very important part of most children’s learning experience. Why, then, is there so much controversy surrounding preschool eye examination initiatives?
Recently, we’ve explored this issue in our Children’s Vision Initiative Special Report (March 2002, pages 6-9, and April 2002, pages 9-12). What we’ve learned is that despite the obvious logic and merits of preschool comprehensive eye examinations, there are those who disagree with the initiative. And they generally disagree with it for one of three reasons – it’s not necessary, it’s too expensive to implement or it’s merely an attempt by optometrists and opticians to generate business. Let’s take a look at each.
Are mandated preschool comprehensive eye examinations even necessary? Certainly, I am grateful for the efforts of our community pediatricians and school nurses. They do an excellent job – given their limited resources and time constraints – at identifying children with reduced distance vision in one or both eyes.
However, vision screenings frequently identify mildly myopic, often asymptomatic children who are exceptional students. Not necessarily the kids we’re afraid will “slip through the cracks.” Only a comprehensive eye examination is likely to capture those with latent hyperopia or binocular vision disorders.
Are mandated preschool comprehensive eye examinations too expensive? There’s no doubt that such a program will come with a cost. These are difficult economic times in which virtually every state is struggling to close a deficit. However, doing nothing may prove far more costly to society over time.
Poor school performance can result in a child who underachieves, is less productive and becomes disenfranchised later in life. This isn’t to imply that all of society’s ills stem from poor vision. However, a preschool comprehensive eye examination identifies at-risk children in a timely fashion. Certainly, good news for the child … and society.
Finally, are preschool comprehensive eye examinations an attempt by optometrists and opticians to “drum up” business? I hardly think so. First, these initiatives specify that the eye examination is performed by either an optometrist or ophthalmologist. In fact, the majority of these children will not even require eye wear. This isn’t about putting normally sighted children into corrective eye wear. It is about an intervention for children who need help. Furthermore, just consider Vision USA, See To Learn and the myriad of other programs in which we provide services regardless of one’s ability to pay. This is not about money.
In the final analysis, this initiative is very much in line with Health and Human Service’s Healthy Vision 2010 initiative. I’m confident that it will eventually prevail. Not as a professional turf battle victory. Not as political “pork.” But because it’s what’s best for the kids.