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States Fail to Look for Eye Trouble in Kids

Most aren't screening for problems like 'lazy eye,' report says

THURSDAY, July 28, 2005 (HealthDay News) -- States are short-sighted when it comes to protecting their children's eyesight.

Only one -- Kentucky -- requires all children to receive an eye exam by an eye doctor before starting elementary school. And most other states fall far short of what's needed, according to a new report from the Vision Council of America called Making the Grade.

The report follows a recent U.S. Centers for Disease Control and Prevention review that found that nearly two of three children receive no preventive vision care before entering elementary school.

"We were alarmed by that and decided to take a look at what policies were in place to protect children and their vision before starting school," Joe Lamountain, vice president of strategic communications for the Vision Council of America, said during a teleconference Thursday.

Dr. Joel Zaba, spokesman for the Vision Council of America and an optometrist and child development specialist in Virginia Beach, Va., added, "We have to realize how important vision is for our children. Eighty percent of what they learn is through the visual processing of information."

According to the report, preventive vision care is critically important. Amblyopia, the leading cause of vision loss in children, affects half a million preschoolers. This condition, also known as "lazy eye," can be corrected. If it is not treated or is inadequately treated, the condition and vision loss can become permanent, the report said.

Vision problems also result in cognitive, emotional and behavioral problems. "There are social and emotional consequences," Zaba said. "Children see friends completing work they're not completing and it's very frustrating. Sometimes they will just avoid close-up work or watch TV for hours."

Preventive vision care can take the form of basic vision screening or more comprehensive eye exams. Vision screening relies on a chart pioneered in 1862, Zaba pointed out. Eye exams are only performed by an eye doctor and are the more effective method.

Yet efforts to make the tools more available are sorely lacking.

According to the report, 19 states have no requirement for children to receive preventive vision care before starting school or during the school year. Those states are Alabama, Arizona, California, Idaho, Iowa, Mississippi, Missouri, Montana, Nevada, New Hampshire, New Mexico, North Dakota, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Wisconsin and Wyoming.

Thirty states and the District of Columbia require vision screening, but 29 do not have any follow-up requirements for children who fail the exam. The 30 states are Arkansas, Alaska, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Kansas, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nebraska, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Tennessee, Texas, Utah, Vermont, Virginia, Washington and West Virginia.

Massachusetts and Arkansas are the two states that require children to receive follow-up care if they fail an eye exam.

The report pointed to some progress.

Arkansas, Kentucky, Massachusetts and Ohio have enacted or enhanced existing laws since 1999 to increase the number of children receiving eye exams by eye doctors. The Ohio and Massachusetts laws require eye exams for children with special needs.

After Kentucky enacted its law in 1999, studies showed that 14 percent of children in the state required some form of treatment.

Legislation has also been introduced in the U.S. House of Representatives to provide states with more funds for public education and eye exams. The bill has been endorsed by 145 members of Congress.

"This is a way to do something very tangible to have very good results," Rep. Bill Pascrell (D-N.J.), one of the sponsors of the bill, said at the teleconference.

The report also called on states to enact or enhance laws requiring preventive vision care.

Although Zaba said it's never too late to have your vision tested, the consensus in the medical community is the earlier, the better.

"You like to see kids before the age of 3. That's when ambylopia responds best to treatment," Lamountain said.

More information

To learn more about children and eye care, visit The Optometrists Network.

SOURCES: July 28, 2005, teleconference with Joel Zaba, M.A., O.D., spokesman, Vision Council of America, and optometrist and child development specialist, Virginia Beach, Va.; U.S. Rep. Bill Pascrell, D-N.J.; Joe Lamountain, vice president of strategic communications, Vision Council of America; Vision Council of America's Making the Grade report
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