Eye Exams - Unite For Sight
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Community Fellow,
More than 40% of blindness in the U.S. could be prevented or cured by provision of appropriate treatment in a timely fashion. Unfortunately, about half of blinding eye disease remains undetected. Cost and lack of sufficient insurance is the most important barrier to getting an eye exam by an eye doctor. Needless blindness can be avoided by educating people about going to an eye doctor regularly.
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You are in a unique position to educate your clients about the importance of regular eye exams. You can connect families, adults, and children with free eye care.
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Discovering vision problems early on in a child’s life is an important part of helping him or her do well in school. Avoid frustration Make reading easier Make learning more enjoyable
In the case of some vision conditions (covered later), early detection and treatment is the only way to prevent loss of sight in the afflicted eye
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The following may be indicative of a child experiencing a vision problem: • • • • • • • • •
Eyes turning inward or outward Squinting Headaches Worsening academic performance Blurred or double vision Losing place while reading Avoiding close work Holding reading material closer than normal Rubbing eyes
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Eyes tiring while reading or doing other schoolwork Turning or tilting head to use one eye only Making frequent reversals while reading or writing Using finger to maintain place while reading Consistently performing below potential
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If you notice a child struggling with any of these symptoms, he or she may be experiencing a vision problem The next step is to make sure that child has an eye exam by an eye doctor
Vision screenings (insignificant)
Performed by nonspecialist health staff Provide baseline VA Do not test for eye disorders, cannot provide diagnostic information
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Eye Exams Performed by optometrists or ophthalmologists Thorough Can detect many vision problems and/or eye disorders and diagnose them
Test only distance visual acuity. Fail to detect children who have reading problems, hyperopia, or astigmatism. Vision screenings are subjective ◦ A research study found that two school nurses matched on their vision screening results for only 86.4% of the students. Ore, L., Tamir, A., Stein, N., and Cohen-Dar, M. “Reliability of Vision Screening Tests for School Children.” Journal of Nursing Scholarship. 41.3 (2009): 250-259.
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A study in New York City schools found that 41% of children who passed a distance visual acuity test still needed to be examined by an eye doctor for other reasons. Screening solely for reduced visual acuity may miss up to 40% with potential vision problems. Bodack, M., Chung, I., and Krumholtz, I. “An Analysis of Vision Screening Data from New York City Public Schools.” Journal of the American Optometric Association. 81.9 (2010); 476-484.
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Do not assume that children with eyeglasses have recently had an eye exam. A research study found that 49% of eyeglasswearing children failed a visual assessment. 28% of non-eyeglass-wearing children failed the visual assessment. “Children Unable to Perform Screening Tests in Vision in Preschoolers Study: Proportion with Ocular Conditions and Impact on Measures of Test Accuracy.” Investigative Ophthalmology and Visual Science. 48 (2007):83-87.
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A research study was conducted in California high schools among students who were identified by their teachers as “poor readers”. 17% of the students had deficient visual acuity (20/40 or worse in one eye) 80% of the children were inadequate or weak in at least one of the following visual skills: binocular fusion ranges at near, accomodative facility, and convergence near point. 80% of the students passed the visual acuity testing, but only 20% had adequate visual skills. Grisham, D., Powers, M., and Riles, P. “Visual skills of poor readers in high school.” Journal of the American Optometric Association. 78.10 (2007); 542-549.
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Visits to an eye doctor can be expensive Not everyone has health insurance that covers the cost of eye exams CHIP
◦ Each state has the Children’s Health Insurance Program (CHIP) which can cover the cost of eye exams for children of families that qualify ◦ For information on your state’s program, go to www.insurekidsnow.gov ◦ You can also call (877)-KIDS-NOW
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Vision USA ◦ Through the American Optometric Association ◦ Provides basic eye care services for those who are uninsured and do not qualify for government assistance ◦ http://www.aoa.org/visionusa.xml ◦ (800)-766-4466
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Have a job or live in a household where there is one working member No vision insurance Income below an established level based on household size No eye exam within two years
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EyeCare America ◦ Through the American Academy of Ophthalmology ◦ Provides basic eye care services for those who are uninsured and do not qualify for government assistance ◦ www.eyecareamerica.org ◦ 1-800-222-EYES (1-800-222-3937)
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Senior citizens ◦ 65 and older ◦ Have not seen an ophthalmologist for at least 3 years ◦ No health insurance covering eye exams ◦ U.S. citizen
Those at risk for glaucoma ◦ Have not seen an ophthalmologist for at least 1 year ◦ At risk for glaucoma (family history, race, age) ◦ No health insurance covering eye exams ◦ U.S. citizen
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Many people are not aware that Medicaid and Medicare cover eye exams.
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Nearsightedness (myopia) ◦ Most common visual problem among students ◦ A type of refractive error ◦ Close objects are clear ◦ Far-away objects are blurry ◦ Students may squint to see blackboard or presentation materials ◦ Can be corrected with corrective lenses such as glasses or contact lenses
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Farsightedness (hyperopia) ◦ Also a common visual problem among students ◦ A type of refractive error ◦ Close objects are blurry ◦ Far-away objects are clear ◦ Students may squint while reading or hold reading material farther away from face than normal ◦ Can be corrected with corrective lenses such as glasses
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Lazy Eye (Amblyopia) ◦ One eye is stronger than the other ◦ Student may show signs of strabismus, but the two do not always co-occur ◦ Over time, the brain may begin to disregard signals from the weaker eye ◦ If it is not detected early, amblyopia can lead to a permanent loss of sight in the weaker eye ◦ This disorder is only detectable through an eye exam from an optometrist or ophthalmologist
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Pink Eye (Conjunctivitis) ◦ Common in schoolchildren ◦ The conjunctiva (lining on eyelid and part of eyeball) become infected and inflamed ◦ Highly contagious ◦ Prescription eye drops can treat bacterial forms ◦ Viral forms clear up on their own and cannot be treated, but sometimes eye drops are needed to relieve inflammation.
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Lens of the eye becomes clouded ◦ Most common in older people ◦ Clouded, blurred, or dim vision ◦ Sensitivity to light and glare ◦ Halos around lights ◦ Fading of dolor ◦ Treatment: outpatient surgery to remove clouded lens. Mission Cataract USA covers the cost of cataract surgery for those eligible. Call 800-
343-7265 www.uniteforsight.org
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Increase in fluid pressure inside the eye leads to irreversible damage. ◦ Loss of peripheral vision, and leads to eventual blindness ◦ High risk groups: African Americans over 40, everyone over 60, and those with a family history of glaucoma
Vision changes are very gradual and usually not noticeable until permanent and severe vision loss occurs Treatment: medication and/or surgery
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Those with diabetes can develop diabetic retinopathy. Blood vessels in retina become damaged Diabetic patients should have an eye exam at least once per year.
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