No. 6: KY to require pre-school eye health exams

April 12, 2013

Editor’s Note: To commemorate 50 years of groundbreaking news in optometry, we are publishing the Top 10 AOA News stories as selected by our readers from all five decades. Please share your commentary and personal stories on the site as well (http://connect.aoa.org). The AOA News ran the following article in June 2000.

Kentucky has become the first state in the country to require eye examinations for children prior to entry into preschool, Head Start or kindergarten.

House Bill 706 was signed into law by Gov. Paul Patton (D) April 4 as part of his Early Childhood Initiative.

The law goes into effect July 15, so all children entering school this fall must meet the exam requirement.

Exam documentation must be received by the school systems by Jan. 1 following school entry.

“We do want to stress that this is an exam not a screening,” said Kentucky Optometric Association Executive Director Darlene W. Eakin. “The law requires this by an OD or MD. It’s an unprecedented program that’s been our biggest success of the year.”

The law charges that the soon-to-be-formed Early Childhood Committee “shall work with local entities, including but not limited to health departments and service providers, to establish to the extent of available funding an eye examination program for children who are not eligible for the Kentucky Children’s Insurance Program or Medicaid, and who do not have insurance coverage for an eye examination.”

The state budget has allotted $300,000 for those families who do not qualify for other assistance.

According to the KOA, the Kentucky General Assembly pursued the law after studying early childhood development and finding that vision problems are one of the major factors in limiting children’s abilities to learn and succeed.

The KOA drew Gov. Patton’s attention to the importance of early childhood vision exams.

“He actually read the info,” said AOA State Healthcare Legislation Committee Chair, Joe Ellis, O.D. “He really became interested in the topic and originally wanted to require exams at age 3. This became the governor’s bill really.”

“We felt it was very important that this be made into law. A recommendation only wasn’t strong enough,” said Eakin. “We thought that if it wasn’t required, many parents simply wouldn’t do it. Many times after vision problems are detected, parents wait up to a year to get the exam. This is the best thing for the kids, helping them develop to their highest potential. It’s going to be a challenge to the doctors.”

The KOA recommends that even if a child’s eyes are examined at 3 years of age (the AOA recommends an eye exam between six and eight months), they should be reexamined at 5.

The Early Childhood Initiative includes many other necessities relating to health care, such as newborn hearing screenings and home health department visits to new parents.

The KOA says that an estimated 80 percent of learning during a child’s first 12 years is obtained through vision. According to the United States Center for Health Statistics, only 14 percent of children below the age of 6 have received a comprehensive eye exam.

Amblyopia, the most serious condition, is responsible for more cases of vision loss in people younger than 45 than all other ocular diseases and trauma combined, says the KOA. Treatment before the age of 5 is critical to reverse the condition.

Nonetheless, the American Journal of Ophthalmology reports that half of all children with amblyopia are diagnosed after age 5 when therapy is no longer effective. Further causing concern is a study by the American Academy of Pediatrics showing that as many as one-third of children who receive a late diagnosis of amblyopia actually had a vision screening as preschoolers, not an examination.

The Healthy Babies Work Group will be established to develop and implement a public awareness campaign.

As part of the effort, resources for parents who cannot afford the eye exam will be publicized.

According to the Kentucky Optometric Association, one-half of all children in Kentucky are eligible for Medicaid or KCHIP. Both programs cover routine eye exams. Vision Service Plan has agreed to provide up to 5,000 coupons for exams through their Sight for Students campaign. For the next two years, $300,000 is available for those not covered under these plans.

“This is really a win-win situation for ODs and kids,” said KOA President Robert Brooks, O.D. “I think it’s a fantastic law that other states will look to. Children simply need this legislation, giving them a chance to begin school on an equal footing.”

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