Hearing is mandated in Arizona for school kids, but not vision.
BY JENNIFER L. MILLER, RN
I am the nursing supervisor for the Yavapai County Education Service Agency (YCESA) in Prescott, Arizona. As a needs-based organization, YCESA provides a variety of services to any interested local schools. Often, these are schools that cannot afford to hire full time staff. The services including nursing, counseling, physical and occupational therapy. The YCESA supports 28 schools in our rural, far-flung county.
Arizona mandates proof of a hearing test for school entry . No such requirement exists for vision. To emphasize the importance of vision screening, our team decided to write a grant. Grant’s goal was to create a screening program in the Prescott Unified School District. The program would ultilize our Plusoptix autorefractor. The school had been using traditional vision screenings methods, which are difficult for preschoolers to comply with. Even some kindergarteners can struggle with eye charts as well as children with special needs.
The Hopeful Ways Nicaragua project provides free eye care services to this impoverished country, using the Plusoptix Vision Screener.
BY JIM CARLINS
The mission of the all-volunteer members of Hopeful Ways is to offer a variety of health services and educational opportunities to the poor in Nicaragua. Our primary initiative, however, is providing free eye care services to the needy. After Haiti, Nicaragua is the Western Hemisphere’s second poorest country. Many of the people we serve have never been seen by an eye doctor. In fact, a pair of prescription eyeglasses could cost 6 months’ wages.
Our program depends heavily on the Nicaragua Lions Club to help coordinate our missions. They do everything from providing transportation to spreading the word in the community and signing up potential patients. Lions Club International is the largest service organization in the world with 1.4 million members from 46,000 clubs in 250 countries.
The eye care services we provide include vision screening as well as full eye examinations, eye surgeries, and even prosthetic eyes. We distribute prescription and reading eyeglasses, sunglasses, safety glasses, and even eye moisturizing drops.
As children get ready to head back to school, we reflect on the importance of vision for learning. Colorado Governor John Hickenlooper released a proclamation recognizing the prevalence of undiagnosed and untreated vision disorders. He states that as many as one in four school-age children has vision problems. Vision problems are the most common disorders among children. Coloradoans are reminded to recognize the importance of education in children’s lives. “Parents are encouraged to have their children evaluated for vision problems to maximize their potential in the classroom,” Gov. Hickenlooper said.
Usually, most children do not need a complete eye examination; however, all children should have serial screenings. Objective, device-based vision screening or photoscreening is an excellent way to accomplish screening in young children. With the right referral criteria in place, screenings in preschoolers can help to identify risk factors for amblyopia. Therefore, children’s screening should be performed yearly.
Recently the American Association for Pediatric Ophthalmology and Strabismus added the option of photoscreening for children ages 12 months to 36 months to its recommendations. If a child fails the screening, it is then referred to an eye care provider for a complete eye examination with dilation.1 Not all children who have a refractive error will need to wear glasses; the treatment will depend on their individual situation and factors such as age and the level of risk for developing amblyopia.
Therefore, it is crucial that there is a follow through when a child is referred with a “Refer” screening result for a complete exam. Communication is key throughout this process, starting with the person who performs the vision screening.
Photoscreening is an efficient and effective method of identifying kids at risk for amblyopia.
The Kodiak Area Native Association (KANA) serves a 12,000-member community located on a large, mostly uninhabited island in Alaska. I am a Developmental Specialist with the KANA Infant Learning Program. This is a part of the Alaska Early Intervention system that works with young children, who are experiencing developmental delays, or are at risk of developing such delays, and their families.
KANA collaborates with Alaska Blind Child Discovery (ABCD), a cooperative, charitable research project to conduct vision screening on every preschooler in Alaska. ABCD is the brain child of pediatric ophthalmologist Robert Arnold, MD. During his pediatric fellowship at Indiana University, Dr. Arnold became intrigued with detecting small-angle strabismus using the Brückner Test. After starting practice in Anchorage with Ophthalmic Associates in 1989, he began publishing clinical research around modifying the test. As his interest in photoscreening advanced, Dr. Arnold began working with public health nurses, and later various charities to launch screening clinics in urban and remote villages.
“Working to educate the community about the value of early childhood vision screening with the platform that Miss Colorado has provided me has been a very rewarding experience. By sharing my story, I hope I convince more people to support and participate in screening programs.”
“Really? Now we should photoscreen all kids over the age of 1 year? What else can they put on us.” That was my first thought when the American Academy of Pediatrics, the American Academy of Ophthalmology, and the American Optometric Association updated their screening policy statements in 2015 to include recommending photoscreening for children ages 1 to 3.
After our group of five independent pediatricians calmed down and thought about the idea, however, we realized that this new technology was probably far superior to the old methods we employed to screen vision. We researched the available products, seeking the tool that would accomplish screening with the highest specificity and sensitivity. The tools varied in cost and sophistication from cell phone apps to more expensive screening devices. We collected data on the options and presented it to the optometrists and pediatric ophthalmology groups to whom we refer. We asked them, which of these products would you want us to use on your child? They understand that over- and under-referrals are real issues in our community, and they want to prevent them as much as we do. They all picked Plusoptix. Continue reading “VISION SCREENING IN PRIMARY CARE – It is time to get onboard”
Welcome to the Plusoptix Amblyopia Screening monthly blog where readers can learn more about the importance of amblyopia screenings and follow-up eye exams in early childhood as well as other key topics related to kids’ eye health.
Vision screening that requires a child to respond to an eye chart has been shown to have poor predictive value, especially in the first 3 to 4 years of life.(1) Instrument-based vision screening, however, can detect abnormalities that could lead to permanent vision loss. Plusoptix, founded in 2001, is dedicated to the development of binocular handheld photorefractors for babies, children, and uncooperative patients. Plusoptix vision devices screen for hyperopia, myopia, astigmatism, anisometropia, anisocoria, and strabismus. A number of these conditions are considered risk factors for amblyopia, which can cause partial or full blindness if not treated. The goal of amblyopia screening is to detect vision disorders in the first few years of life and to and treat early when therapy has the best chance of being successful. Continue reading “Welcome!”
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