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Improved vision screenings may improve children’s chances for success
While training at the Pennsylvania College of Optometry, one of my external clinic rotations was at Holmesburg Prison. Holmesburg, a maximum security correctional facility with a violent and sordid past, was home to many of the Eastern Seaboard’s most hardened criminals.
While ever mindful of why my patients were there in the first place, I was, nonetheless, always struck by two oddities. One was just how cordial, cooperative and appreciative the inmates generally were. The other was the consistency with which inmates presented with significant visual disability. Whether it was a large uncorrected refractive error and associated amblyopia or undiagnosed keratoconus, I often marveled at how poorly they saw and could not fathom how they were able to navigate life.
Unfortunately, the history was all too familiar – limited or no access to eye care, poor academic performance and subsequent dropout, limited career options and, eventually, a life of crime that often resulted in incarceration, often at a very early age.
Granted, I am in no way an expert on the criminal mind. I fully recognize there are a multitude of factors – innate and environmental – ultimately responsible for an individual landing in prison. But every time I walked out of Holmesburg’s medical clinic, I could not help but wonder: What if? What if a particular inmate had timely access to eye care, proper treatment and ultimately a better chance of doing well in school? What if they earned a degree and embarked on a meaningful career? What if they had a sense of being a productive member of society?
Michael D. DePaolis
While Holmesburg is undoubtedly an extreme example, every day all of us encounter our own what ifs. Over the years we accumulate a cadre of patients in which early intervention has proven critical in mitigating everything from amblyopia to blindness, where treatments ranging from corrective lenses to visual therapy have led to improved school readiness and academic performance, and where eye care has made a profound difference in a child’s life.
This is the very reason optometrists have embraced programs such as InfantSee and why we are so passionate about mandated comprehensive eye examinations for children. While everyone agrees a comprehensive eye examination provides more information than a vision screening, the reality is it will likely be some time before annual examinations for every child in America become a reality. This is precisely why vision screenings are so valuable – valuable, however, only if done correctly.
In this issue of Primary Care Optometry News, I encourage you to take a few minutes and read our feature article, “Experts advocate vision screening guidelines for preschool children” . The guidelines, derived from a thorough review of evidence-based literature, detail best practices – testing and technique – for effective vision screening. They also provide us with the tools to better educate pediatricians, school nurses and others conducting vision screening.
While improved screenings lead to better detection, appropriate referrals and earlier intervention, they ultimately help us achieve the most important goal: a safety net for our children … and a chance to eliminate the “what ifs.”