Eyeing the Future

Last January with little fanfare, Illinois became the third state, along with Kentucky and Missouri, to require that all students entering kindergarten or enrolling for the first time receive a comprehensive eye exam.

While few can argue about the benefits of catching vision problems early, there is concern about the motivation of this mandate, the cost of the exams and whether there will be enough doctors available to do all the screenings.

Five-year-old Isabelle Auer is gearing up for the start of school. Along with her typical kindergarten school supplies, her parents were surprised to learn she needed one more item - a pair of glasses.

"I never even noticed she had a problem before. They said her eyes were wandering. They picked it up from the exam right away," said mom Heather Auer.

Heather Auer says her daughter's recent checkup at the eye doctor revealed Isabelle was having focusing problems due to amblyompia, or lazy eye.

Loyola optometrist Eileen Gable says many times there are no symptoms. And the problem can only be found by a professional.

"What had happened in the past was, the school screenings were found to be somewhat inadequate. Children were screened, and not all of their conditions were found out," said Gable.

Advocates of a new Illinois law mandating eye exams say that's why these exams, by a listened eye care specialist, are needed. So as of this fall, all children entering Illinois schools for the first time will need a comprehensive eye exam.

"It's not that we're trying to push glasses on anyone, it's just we are trying to find out what can impact the life of your child and make a difference early," Gable said.

This is not the same type of screening done in schools. It's more involved and, depending on the child, could include eye drops to dilate the eyes.

Five-year-old Journee Dortch had a hard time with the drops, but her mother says the exam is worth it.

"I would not want her to have any issues, especially when they are going to begin to read and start to write," said mom Kendra Wilkerson.

"When you detect a problem this early, the likelihood of taking care of that problem and preventing long term vision loss is much higher than at 6, 7 or 8," Gable said.

Proponents of these exams also believe optimal vision translates into better learning.

But some people are starting to wonder if there's really a need. Among other concerns, there's the question of cost and whether there are enough eye care professionals to handle the exams. There have also been complaints that this mandate is really just a moneymaker for eye specialists and that as a result, glasses will be over-prescribed to children.

Ophthalmologist Michael Kipp, with the Wheaton Eye Clinic, is treating Isabelle and said she's definitely a good example of a child who benefited from the full exam. But he and other doctors still wonder if the mandate is a poor use of resources.

"The hassle for the parents and the overload of eye doctors schedules," Kipp said.

Kipp also thinks the screenings that are currently provided in schools are good but could be better. And a recent editorial in the Journal Ophthalmology is also questioning the evidence behind mandating these examinations.

Dr. David Wallace argues in favor of doing the test earlier and questions whether these exams will deter learning problems or prevent permanent eye damage. He added, "A comprehensive eye examination done before entering school is poorly timed and would likely result in glasses prescribed unnecessarily for many children."

Heather Auer feels fortunate her daughter had the exam and says the glasses are making a difference.

"It's helping her be able to focus better and help her with depth perception," she said.

The Illinois Optometric Association agrees early screening of children as young as 3 to 4 years old would be ideal but says there's no way of reaching out to this age group until they get to elementary school. They added that most insurance will now cover these costs. Parents have until October 15 to get their children examined. If they don't, the school may withhold report cards.

Loyola Univ. Health Systems
(888) LUHS-888

Wheaton Eye Clinic

Illinois Optometric Assoc.
All Kids Medicaid Assistance

American Academy of Ophthalmology

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