Our Vision That all children receive a proper vision screening or examination within one year of beginning school and periodically throughout; and that those who fail a vision screening receive a full eye examination.

Prevent Blindness America 2020 Visionary Goal

Prevent Blindness America has established a core of three visionary goals for special attention between now and 2020 – one each to address children’s vision and eye health, adult vision and eye health, and eye safety. The child-focused visionary goal is to reduce vision loss by ensuring that all children receive appropriate vision care as they enter school.

What We Know

• More than 12.1 million school-age children, or one in four, have some form of vision problem, yet only about 21 percent of preschool-age children have their vision screened, and only an estimated 14 percent of children receive comprehensive eye examinations before entering kindergarten or first grade.^1,2




• Approximately 80 percent of what a child learns is done so visually.³




• According to the CDC, impaired vision can affect a child’s cognitive, emotional, neurologic and physical development by potentially limiting the range of experiences and kinds of information to which the child is exposed.⁴




• Requirements for preventive eye care prior to or during the school years vary broadly from state to state, with little consistence regarding type, frequency, referral or follow-up requirement protocol. ⁵




• A study of the Michigan hearing and vision screening programs found that during the 2000-2001 school year, most children received follow-up care after an abnormal screen.⁶

Our Positions

Prevent Blindness America supports public health efforts to ensure that vision problems do not unnecessarily detract from children’s ability to learn. In support of this position, Prevent Blindness America endorses state-based legislative efforts to mandate that all children are screened for vision problems prior to school entry, with appropriate follow-up eye examinations when necessary.⁷

Such legislation should include several key components:

• the establishment of key elements of an authorized pediatric vision screening, following nationally-recognized pediatric vision screening protocol;




• the establishment of the parameters for authorizing lay vision screeners;




• a requirement of follow-up comprehensive eye examinations for children failing the screening;




• the establishment of key elements of a mandatory vision screening program, to include required dates, notification processes and alternatives to screening; and




• the creation of an oversight commission where an appropriate body does not exist.

In advancing these proactive efforts to children’s school-entry vision screening legislation, Prevent Blindness America intends that no child be deprived of their rightful educational opportunity due to the enactment of such legislation; that the state should ensure adequate funding for such efforts; and that school-entry screening legislation should not supersede existing legislation related to vision screening throughout the primary school years, which is encouraged. If such regular ongoing vision screening is not already in place, we support efforts to require its inclusion.

Though we support efforts to ensure that children receive periodic professional eye care as a part of a continuum of preventive vision and eye health services, we do not endorse efforts to mandate full eye examinations for all children prior to school entry. However, should such efforts be advanced, we believe these mandates must, at a minimum, 1) not withhold educational opportunities or otherwise penalize children; 2) include adequate additional fiscal and other resources for monitoring and enforcing compliance; 3) provide sufficient means to deliver the required eye care to children whose families cannot afford to purchase that care; 4) accept any examination that includes the appropriate procedures and that is performed by a healthcare provider acting within his or her legal scope of practice; 5) not undermine existing preventive vision and eye health services such as community- or school-based vision screening nor in any way hinder the continuation or development of such programs; 6) not hinder safety net programs; and 7) include appropriate measures for the timely assessment of their effectiveness in terms of relative economic costs and benefits in order to determine whether or not they justify the burden placed on parents, school and public health systems, and the society at large.

Finally, Prevent Blindness America supports efforts to mandate eye examinations for all children with special needs, as these children have higher rates of vision problems and may be misdiagnosed with a learning disability due to their vision problem.

Our Efforts

In the best interests of the nation’s children, Prevent Blindness America commits to a long-term comprehensive campaign to ensure all states have in place mandatory school-entry vision screening legislation that meets a checklist of minimum standards, to include a mandatory exam component for failed screenings, by:

1. Promoting model legislation on mandatory pediatric vision screening, to include a mandatory exam component for failed screenings.




2. Designing a checklist of minimum legislative standards that Prevent Blindness America will use to endorse pediatric vision screening legislation on a state-by-state basis.




3. Cataloguing existing state legislation related to vision screening and exams.




4. Creating a priority ranking of states to focus the campaign’s efforts, utilizing a variety of standards, such as existing legislation, activity of potential local partners, sense of the state legislative climate, population, etc.




5. Enlisting Prevent Blindness America affiliates and other state partners as active members of this campaign, each committed to ensuring the passage of mandatory pediatric vision screening legislation in their respective states.




6. Creating a communications strategy and plan for the campaign.




7. Creating an online resource center, dedicated to the campaign, to provide state-by-state information and resources on pediatric vision screening-related advocacy.




8. Distributing collateral materials through the legislative networks of all 50 states.




9. Working with members of Congress and partner organizations toward the passage of the Vision Care for Kids Act, to provide needed support for public education and follow-up care to the states.

References

1. Donahue SP, Johnson TM, Ottar W, Scott WE. Sensitivity of photoscreening to detect high-magnitude amblyogenic factors. J AAPOS. 2002;6:86-91.
2. Poe GS. Eye Care Visits and Use of Eyeglasses or Contact Lenses. United States 1979 and 1980. Hyattsville, MD: US Department of Health and Human Services; 1984. Vital and Health Statistics Series 10, No. 145. DHHS publication 84-1573.
3. Ottar WL, Scott WK, Holgado SI. Photoscreening for amblyogenic factors. J Pediatr Ophthalmol Strabismus. 1995;32:289-295.
4. National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention. What is Vision Impairment? October 29, 2004. http://www.cdc.gov/ncbddd/dd/vision2.htm.
5. Naser N, Hartman EE. Comparison of state guidelines and policies for vision screening and eye exams: preschool through early childhood. Poster presented at Association for Research in Vision and Ophthalmology annual meeting. 2008.
6. Kemper AR, Fant KE, Bruckman D, Clark SJ. Hearing and vision screening program for school-aged children. Am J Prev Med. 2004;26(2):141-146.
7. Prevent Blindness America. School Entry Vision Screening Legislation Position Statement. http://www.preventblindness.org/advocacy/model_screening_legislation.html.