Aénisha was having headaches but it never occurred to the 16-year-old that the problem was her eyes.
Now — after a free vision screening led to a free eye exam and then free glasses and free eye drops to prevent the glaucoma that runs through her mother’s family — the headaches are gone, as is the squinting, and her teachers say she participates more in class.
“Kids who can’t see can’t learn,” said Alex Levin, chief of pediatric ophthalmology at Wills Eye Institute, an obvious statement that also sums up a major public health problem.
Research consistently shows that 20 to 25 percent of American school-age children have a vision deficit, which in the vast majority of cases could be easily corrected. Parents may have trouble accessing treatment. They may not realize that a young child’s seemingly minor eye issues might lead to behavior difficulties and, in theory, a lifetime of lower earnings. Or they simply may not notice.
“You can see tooth decay,” said Sarah Martinez-Helfman, executive director of the Eagles Youth Partnership, which sends its eye mobile to a different school every day and is one of several organizations that is sponsoring free screenings and followup treatment for all children on Saturday at Wills Eye, which is affiliated with Thomas Jefferson University Hospital.
Aénisha got her prescription at the last mass event, 18 months ago , when 1,400 children formed a line around the block with their parents starting at 4:30 a.m.
Most states mandate <NO1>at least <NO>basic vision screenings for children in school; Pennsylvania requires it every year, New Jersey every other year. More than 80 percent of Philadelphia School District students are screened annually.
Yet two-thirds of the city children who failed the basic eye-chart screening in the 2009-10 school year never followed up with the vision exam that would lead to a prescription for eyeglasses. And, if the Eagles Eye Mobile is any indication, fewer than 5 percent of the children who did get examined and were subsequently diagnosed with a serious eye problem at a hospital ever returned for critical followup treatment.
About 95 percent of children in the city have insurance, although nearly one-third of those at the last “Give Kids Sight Day” were uninsured and another third had public insurance. Not all coverage includes vision, though, and confusion is common among beneficiaries as well as providers.
Poverty — ability to take off from work, or to make arrangements for several children at once — plays a role.
“The two greatest barriers to care are, One, parents didn’t get it, they just didn’t understand that it was important or that they were supposed to follow up themselves, they just didn’t connect the dots,” said Levin.
“Second, cell phones.”
Lower-income people often buy short-term contracts that lapse when they run short of money. If the phone is replaced later, the number may be different, Levin said, and they also may not answer a call from an unknown number to save money. As a result, nurses and social workers who try to call to explain the need for a visit or to schedule an appointment can’t get through.
“Vision problems cannot be overcome by simply trying harder,” Charles E. Basch, a professor of health education at Columbia University, wrote in a 2010 research review. The demoralization and academic failure that follows lead to disengagement from school, making social and emotional issues more likely, he wrote. Ultimately “a child’s vision problems can affect not only their own learning, but that of their peers.”
Small problems need to be addressed early. If a child’s eyes are not lined up or one doesn’t focus properly — both easily handled with glasses — the developing brain will block neural connections in the bad eye to bolster the good one, said Julia A. Haller, ophthalmologist-in-chief at Wills Eye. The condition is called amblyopia, or lazy eye.
If it is not corrected by age 10, Haller said, “as a teenager, you can have the \[best\] glasses in the world and you will not be able to see” properly.
Three years ago, Levin spearheaded the partnership that aims to prevent these sorts of outcomes. He travels several times a year to packed clinics in developing countries, where people walk 10 miles to see an eye doctor.
“When I looked out the window that first year and saw a line around the block, I had tears in my eyes,” said Levin, who travels several times a year to packed clinics in developing countries, where people routinely walk 10 miles to see an eye doctor.
Here, people can take public transportation.
Annette Strickland, 39, of West Philadelphia, works full time as a parking garage attendant. A monthly income of $1,017 qualifies the single mother of six for Medicaid (and subsidized day care, which she was told would end in June as a result of state budget cuts). But neither the ophthalmologist nor the six optometrists she called to make an appointment for her 7-year-old daughter, who has been complaining about her eyes, would accept Medicaid.
So she is planning to again bring the entire family to Saturday’s screening.
It was there in October 2010 that her eldest, Aénisha Lampkin, got glasses (all kids get two pair) and eye drops to prevent elevated pressure in both eyes from turning into glaucoma. The Communications Technology High School student also got an unexpected boost in confidence that had her try out for softball; she is now catcher and, with her glasses, a decent hitter.
The style glasses that she chose from an “awesome” selection of colors and shapes are rectangular, with pink-and-orange plastic frames.
“I love them. I don’t take them off,” said Aénisha, who will celebrate her 18th birthday Saturday by lining up for another checkup by 7:30 a.m.
Philadelphia Inquirer – April 13, 2012 – Read article online