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Dr. Pierce responds:
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These statements miss the point that many children in the U.S. are living with significant psychosocial adversity, are socially isolated and are unable to attend to their learning environments by relying on outdated systems of vision prevention/screening.
This perpetual, but preventable, situation can only be overcome by assuring comprehensive eye exams for all children by an eye doctor. Let’s do work collaboratively (ie, optometry and ophthalmology) to assure that this basic/essential level of vision care is provided to all children by the start of first grade. Let’s also accept this as a starting point to work together to improve clinical vision and eye health pediatric care.
The necessity of making such an effort now is highlighted by a recent “call to action” by the CDC to implement new evidence-based strategies (eg, eye examinations for all children), report on the reasons why those approaches work and track their effect on implementation and population health.
Engaging this form of translation and implementation research will help us address vision population health and inequalities. This translation research should be integrated with behavioral mental health professionals and pediatricians to increase the reach or adoption of this intervention (ie, eye exam for all children before first grade) until a critical mass is attained and the entire target population is engaged (ie, scalability) (Pronk et al.). This stage has been set by recent rules that describe this care as essential pediatric vision care.
Scalability of this essential pediatric vision care will take a team approach to foster policy and program development, to deliver and measure its intended benefits (increased matriculation from high school, reduced ADHD medications, reduced Individualized Education Plans and reduced juvenile incarceration). We need to think and act differently if we expect to see an improved outcome of children’s vision health in the U.S. Please join us in this.
- References:
- Estabrooks PA, et al. Preventing Chronic Disease. www.cdc.gov/pcd/issues/2018/18_0525.htm. Posted Dec. 20, 2018. Accessed February 20, 2019.
- Pronk NP. Disease Management and Health Outcomes. 2003;doi:10.2165/00115677-200311030-00002.
Samuel D. Pierce, OD