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Why Eye Care for Children is Essential in Community Health Centers

It’s estimated more than 8 million children in the United States get their primary health care from a community health center. As children prepare to return to school this summer, eye examinations should be at the top of the list.

Poor vision health severely impacts how children perform in school and their quality of life, essentially resulting in billions of dollars in medical expenditures each year. In 2013, the total economic burden of vision loss and blindness in the United States was estimated to be $139 billion, and treatment of eye-related disorders totaled more than $68.8 billion in annual direct medical costs. While vision problems are often associated with age, low-income and ethnic minorities are at an elevated risk for eye problems. To assist with the national problem, federally funded community health centers around the United States are designing comprehensive care programs in underserved communities to address health disparities and improve access to care.

In April 2006, the Centers for Disease Control and Prevention developed the Vision Health Initiative, an expert panel tasked with addressing poor vision health as a public health crisis. The members of this panel assisted in identifying gaps and solutions to guide future actions and expand opportunities for ongoing collaborative efforts in the vision community. An example of an eye disorder that is affecting children around the world is myopia. The prevalence of myopia is increasing in the United States and is the leading cause of distance impairment globally. Otherwise known as nearsightedness, myopia occurs when the eye grows too long from front to back. Instead of focusing images on the retina, images are focused at a point in front of the retina. As a result, people with myopia have good near vision but have trouble seeing objects in the distance.

Myopia Increases Sight Threatening Eye Diseases

According to a report released in 2015 by the World Health Organization, based on the world-wide prevalence of myopia, it can be estimated that 1.89 billion people are myopic. In recent years, there has been considerable speculation on the role of electronic devices including computers, tablets, smartphones, and video games may have played in the increase of myopia. In Taiwan, legislative action has been taken to limit the use of electronic devices in young children. Concerns about electronic devices seem to be based on the belief that myopia is now appearing in pre-school aged children, compared to 1983 when device use was not common in 18-year old Taiwanese schoolchildren.

The Brien Holden Vision Institute released a study in 2016 and concluded that almost half of the world population will have myopia by the year 2050 and that nearly one billion people will have high myopia. Those numbers are staggering and would be a seven-fold increase in high myopia compared to the year 2000.

In June 2018, thirty-three eyecare industry experts and leaders met in Denver, Colorado, to discuss how to raise public awareness around the growing magnitude of childhood myopia. The group, also known as the Myopia Awareness Coalition (MAC) is represented by manufacturers, retailers, insurers, eye doctors and researchers, all with the goal of increasing public awareness around myopia. To be successful in generating awareness around myopia, MAC members agreed it’s important to partner with large organizations such as the World Health Organization, Prevent Blindness, the American Optometric Association, the American Academy of Ophthalmology and many others to coordinate resources to further educate the public on the growing issue.

What Solutions Are Available to Prevent Vision Loss in Children?

school nurse conducting eye exams on school children

Changes in vision are normal, but the best way to prevent vision loss and blindness is to have an eye exam regularly, even before symptoms arise. Providing on-site vision assessments at community health centers by means of a comprehensive eye exam or with a handheld portable vision screener, is as important and urgent as ever. The American Academy of Pediatrics (AAP) and the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) has recommended the use of photoscreening instruments in children, when available, to start at 12 months and at each annual well visit through five years of age, or until visual acuity can be reliably assessed with eye charts.

Portable devices such as the Welch Allyn Spot™ Vision Screener are ideal for community health centers as they are easy to use and can detect up to six amblyopic risk factors including myopia. Automated screening provides thorough, objective results in seconds and its intuitive design makes it easy for healthcare providers, school nurses and volunteers to capture results in seconds. It’s important to note Spot Vision Screener can be used as a pediatric vision screener to refer children with vision problems for a comprehensive eye exam.