October 24, 2017

School eye exams unveil problems

Author: Liza Frenette
Source: NYSUT Communications
optometry
Caption: Young students may not realize their vision is skewed, says Jenelle Mallios, chief of pediatrics and assistant clinical professor at the State University of New York College of Optometry. Mallios is a member of United University Professions’ Optometry chapter. Photo by Louie Bacosa.

Eye problems not identified in school vision screenings were discovered this month in students at seven high-needs districts chosen for free exams in an inaugural State Education Department program.

“There was a much higher incidence of amblyopia (lazy eye) than the normal population,” said Jan Dorman, executive director of the New York State Optometrics Association, an organization that partnered with SED and Vision Service Plan for the new student eye care program. The optometrists who volunteered for the program “were surprised” by how many students had this condition, he said. It reduces vision because the eye and the brain are not working together properly.

“It can lead to blindness in one eye,” Dorman said.

The new program for Vision Health Month — October — debuted at seven schools where 152 students were examined and provided free eyeglasses if needed. Additionally, 275 gift certificates were left behind with school nurses to be used for other students who may need exams and eyeglasses. Economic criteria are used to determine which students receive the exams.

Students were visited at schools in East Aurora, Salamanca, Minoa, Waverly, Ellenburg and Fort Edward. Dorman said that, next year they hope to expand the program to at least 20-25 schools.

Students identified as having learning problems sometimes have undiagnosed eye problems that are not identified on a vision screening, such as the ones that schools are required to provide. These screenings test for distance acuity, near vision and color perception. Other problems can go undetected.

“Teachers have definitely noticed instances where students were not getting the help they needed,” said Marianne Stark, local union president and sixth-grade teacher at Fort Edward, one of the high-needs schools chosen for the free program. Access to eye care in remote areas can be difficult, and paying for eye exams and glasses can be cost prohibitive to some families.

Jenelle Mallios, chief of pediatrics and assistant clinical professor at the State University of New York College of Optometry, said a comprehensive eye exam checks the need for glasses and health of the eye, and also for depth perception; the child’s focusing system; how the eyes are tracking; and how the eyes are being used together. For some children, words can seem to float off the page. Blurriness when viewing objects or words up close – which happens in the same way a camera lens can blur an object when it is too close – can also be an unidentified problem.

In this situation, a student overuses neuromuscular reserves to attempt to see straight.

“We look for children with convergence insufficiency,” Mallios said. “One eye turns out while they’re looking up close. Imagine what happens to the eyes while they’re trying to read.”

A young student may not realize their vision is skewed. “They might not think it’s abnormal. That’s all they know, said Mallios, a member of United University Professions’ Optometry chapter.

Proper eyeglasses and vision therapy can be used to correct binocular vision problems.

Ambylopia, for example, could be diagnosed at a young age; the dominant eye would be patched for six to eight weeks, forcing the other eye to become more dominant, Dorman said.

In Fort Edward, 65 students received eye exams in the two-week examination period, or more than 25 percent of the elementary population, according to Stark. The eye exams were provided to any student in K-5 that completed the provided paperwork, she said.

Fort Edward is a high-needs school where every student receives free and reduced lunch due to the large number of students who qualify.

“This program was well received and we are hopeful it will continue in the future,” Stark said of the vision care. “ We are hopeful it could be extended to our high school students as well.”

Learning problems in young children can easily be misdiagnosed. The students who have trouble paying attention and look at everything but the smart board, fidgeting with their feet and their backpacks, may very well have a problem with their vision.

“It may seem like a child is misbehaving,” Mallios said. “It can be seen as inattentiveness, but the underlying issue may be visual in nature — i.e. the need for glasses or vision therapy.”

Warning signs that teachers or parents should notice in children include avoiding or disliking reading; short attention span; difficulty copying from a chalkboard; pulling a book in close to their face; frequent blinking or eye rubbing; using a finger or pencil while reading to guide their eyes; and declining performance in school. While all public schools provide vision screenings and referrals to eye care specialists, as needed, comprehensive eye examinations are more difficult to access for some students.

One in four students has a vision disorder, according to the State Education Department, which chose to name October as the first-ever School Vision Health Month to get the word out and the glasses on. The New York State Senate and Assembly joined in highlighting the critical role of proper vision for a child’s social, cognitive and physical development. New York State Optometric Association, VSP Global and the New York State Society of Opticians joined to provide services to students.

NYSED coordinated the no-cost eye exams at the schools where local optometrists, including VSP network doctors, volunteered to provide the eye exams, using portable equipment donated by VSP, which also donated the eyeglasses.

Many children are developing eye problems that stem from too much time on their computers and smart phones, and not enough time outdoors using distance vision.

“It’s straining the eyes,” said Dorman.

“Myopia is becoming more and more prevalent,” said Mallios. “Playing outdoors is helpful in slowing down the progression of myopia.” Contact lenses and eye drops are also therapies for controlling myopia progression.

SUNY College of Optometry in New York City is the only institution of its kind in New York. It is a center for education, patient care and research on vision, where students may earn a doctor of optometry; a master of science in vision science; or a Doctor of Philosophy in Vision Science.

Kim Oliver, SUNY Optometry library outreach and services coordinator, is president of the 193-member chapter of the UUP union, representing the academic faculty and staff who work at the college.

University Eye Center — one of the largest outpatient clinics in the country —provides eye care, glasses and vision therapy to the public. Part of that umbrella of care is its pediatric service.

The Optometric Center of New York, affiliated with the college, supports vision science research, patient care and fellowships at both the college and at its clinical facilities.

The college is in the midst of a capital campaign, Our Vision For Children, to create a Center for Pediatric Eye Care.

“We must recognize that access to proper vision care is a serious concern; statistics show that more than 10 percent of children have not had new or replacement glasses due to unaffordable costs,” said SED Commissioner MaryEllen Elia. “For some families in New York, eye exams and corrective eyewear is simply unaffordable

The American Optometric Association recommends that children see an eye care professional at six months, three years and around five years old. After that, an eye exam should be scheduled at least once a year.

For referrals to optometrists who specialize in pediatric eye care, contact the New York State Optometric Association at (800) 342-9836 or visit it online at www.nysoa.org.

FROM THE DICTIONARY:

  • OPTICIAN: a person qualified to make and supply eyeglasses and contact lenses for correction of vision.
  • OPTOMETRIST: a licensed professional who examines the eyes, by means of suitable instruments or appliances, for defects in vision and eye disorders in order to prescribe corrective lenses or other appropriate treatment.
  • OPTHALMOLOGIST: a physician (doctor of medicine, MD, or doctor of osteopathy, DO) who specializes in the medical and surgical care of the eyes and visual system and in the prevention of eye disease and injury.

RESOURCES

Organizations with pediatric ophthalmology clinics that provide complete eye examinations upon referral include:

Albany Medical Center
Albany, NY
518-262-4353

Children’s Medical Eye Consultants
Slingerlands, NY
518-533-6502

Oshei Children’s Hospital of Buffalo Outpatient Ophthalmology Center
Buffalo, NY
716-859-5437

Western NY Ophthalmology Group
Amherst, NY
716-204-4516

Columbia Presbyterian Morgan Stanley Children’s Hospital
New York, NY
212-305-9535

New York-Presbyterian Komansky Children’s Hospital
New York, NY
646-962-2020

Volunteer ophthalmologists from the New York State Ophthalmological Society make these clinics possible.