Jessica Oberoi, 13, can’t remember exactly when her vision began to blur. He just knew he had to cringe to see the blackboard at school.
It wasn’t until late autumn, when his eighth-grade eye examination in Bloomington, Indiana, showed that he had extremely far-sighted and lazy eyes (amblyopia).
Since then, she has received intensive care, and her ophthalmologist, Dr. Katie Connolly, says Jessica has improved a lot, but her lazy eyes, which cause problems with perception of depth, may never go away.
Connolly, head of binocular and pediatric vision services at the Indiana University School of Optometry, said if her condition had been diagnosed earlier, it would have been much more likely to have been completely cured.
Jessica is one of the countless students affected by the country’s meager efforts to diagnose and treat children’s vision problems.
The Center for Disease Control and Prevention (CDC) estimates that more than 600,000 children and adolescents are blind or visually impaired. A recent JAMA Network op-ed notes that this huge number of children can only be helped with glasses, but due to the high cost and lack of insurance, many do not get help.
The National Survey of Children’s Health, funded by the Federal Health Resources and Services Administration, found that a quarter of children in 2016-17 did not receive regular screening for vision problems.
And a vast majority of these vision problems can be treated or cured if caught early, Connolly said.
“Screening tests are important for kids because they don’t understand what’s unusual,” Connolly said. “They don’t know that their peers around them, or even their parents, realize that their experiences are different.”
Federal law requires that children’s eye examinations be covered by most personal health plans and Medicaid. According to the nonprofit advocacy organization Prevent Blindness’s National Center for Children’s Vision and Eye Health, school-age children in 40 states and the District of Columbia need them and their pre-school needs in 26 states.
Yet many children are neglected. The epidemic has exacerbated the problem since the classes became virtual, and for many students, their eyes are only tested at school. Even after the campuses reopened, school nurses were so overwhelmed by the Covid test that they had to put blanket screenings on their backburners, said Kate King, president-elect of the National Association of School Nurses.
According to the National Center, the problem is most prevalent among children of pre-school age. He noted that a federal survey of children showed that 61% of children 5 years of age or younger had never had an eye examination.
Kindergarten is an important time to examine a child’s vision because they are not old enough to cooperate in eye examinations alone, but only when it is possible to diagnose vision problems, Connolly said.
The CDC survey also found that 67% of children with personal health insurance had eye examinations, compared to 43% of those without insurance.
Ophthalmologists, doctors and school nurses care not only about children’s eyesight, but also about their ability to learn and their quality of life. Both are strongly associated with vision.
“One of the assumptions seems to be that if kids don’t see, they’ll tell someone to let the problems unfold and find out,” said Kelly Hardy, senior general director of health and research at Children’s Now, a California-based children’s advocacy group. But most of the time that doesn’t happen because kids aren’t the best advocates for their own vision problems.
And when left untreated, those problems can get worse or lead to other serious and permanent conditions.
“It seems like a fairly simple, low-tech intervention to ensure kids have a chance to succeed,” Hardy said. “And there are still kids who haven’t had their eyes examined or have had their eyes examined, and that seems unacceptable, especially when there are so many things that are hard to figure out.”
Connolly’s visit to Jessica’s school last year tested Jessica’s eyes for the first time.
Her brother, Tanul Oberoi, 7, accompanied her on a follow-up visit to Connolly’s clinic and had her first eye examination. Her serious vision has been identified and she now wears glasses. Since your condition was caught early, there is a good chance that your vision will improve with glasses.
Sonia Oberoi, mother of Jessica and Tanul, said: “I was surprised they had trouble seeing because they didn’t tell me before.”
Eye tests are only part of the battle, Connolly said. Buying glasses is a luxury for many uninsured families, since the average cost without insurance is $ 351 per pair. The JAMA article noted that in developing countries, hard glasses made of flexible steel wire and plastic lenses can be made for জোড়া 1 per pair, but this option is not generally available in the United States.
Since Jessica and Tanul have no insurance, their mother says the family will have to bear the cost of their glasses. Connolly’s clinic worked with several programs to fully cover her treatment and spectacles, as well as Jessica’s contacts.
The problem goes beyond impaired vision and unknown vision problems. There is a strong link between children’s vision and their development, especially the way they learn. Difficulty seeing clearly can be the beginning of many problems, such as poor grades, misdiagnosis, attention deficit disorder or lack of confidence.
In a 2020 study of Spanish researchers published by the International Journal of Environmental Research and Public Health, students with “poor academic performance” were twice as likely to admit that they could not see the board better than those with good performance.
King, who works at a high school in Columbus, Ohio, said students’ vision problems were ignored even before the epidemic.
Of all the ophthalmologists he referred to, he said, only 15% of children see an ophthalmologist without contacting their parents again. “An overwhelming majority doesn’t follow and there isn’t a full test,” King said.
Another problem is that Medicaid and personal insurance usually cover a pair of glasses every year or two, which King says is not ideal for growing children.
“The school nurses specialize in repairing glasses,” King said with a smile. “We often have to put a new part or a new screw or fix them because a classmate was sitting on them.”
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