Pennsylvania doctors of optometry put high priority on children’s eye health and vision care

When doctors in the Pennsylvania Optometric Association (POA) were asked to make a significant commitment to children’s eye health and vision care, many made the pledge.

To be exact, 215 doctors of optometry as of February 2021 had joined the Pennsylvania Children’s Vision Care Alliance (CVCA). Membership in the alliance requires they commit to making pediatric eye health and vision care a priority—agreeing, among other things, to adhere to recommendations in the AOA Evidence-based Clinical Practice Guideline: Comprehensive Pediatric Eye and Vision Examination.

“They signed up because they care,” says Perry Umlauf, O.D., who chairs the affiliate’s task force on children’s vision. “The POA previously set up this type of collaborative effort with our Pennsylvania Diabetic Eye Health Alliance and CVCA is following suit. One has to give our doctors of optometry great credit for caring about the visual welfare of the citizens of our commonwealth.”

Tracy Sepich, O.D., POA president-elect and member of its children’s vision task force, says, “Our initiatives on behalf of children are now more important than ever, due to the increased use of devices and remote learning.”

The alliance is just one of several POA efforts to optimize children’s vision in the state. It’s a cause shared by the AOA.

On March 24, the AOA is holding the virtual Emergency Children’s Vision Summit at 8:30 p.m. ET. Expert panels on children’s eye health and vision care will assess the crisis and chart a course forward. Doctors, optometry students and paraoptometrics are invited to  register and attend this important summit.

POA takes long view on children’s eye health

According to the AOA’s guideline on pediatric examination, an “estimated one in five preschool children and one in four school-age children in the United States has a vision problem; however, the Centers for Disease Control and Prevention report that less than 15% of preschoolers receive an eye examination by an eye care professional and less than 22% receive some type of vision screening.” Read more about the limitations of vision screening compared to comprehensive eye exams.

The president of the POA, Edward Savarno, O.D., says, "Children’s quality of life is at the heart of our efforts. Doctors of optometry can help level the playing field, so they have a fair shot at life’s opportunities."

How strong is the POA’s commitment to children’s eye care? It goes back a while.

For more than 20 years, the POA has been actively involved in the education of school nurses, teachers and parents on the importance of annual, comprehensive eye examinations.

“It was about that time that we developed the ‘Kids Welcome Here’ program,” Ricci adds. Through the program’s posters and accompanying flyers, the POA’s doctors promoted pediatric eye exams to various audiences. The affiliate licenses the materials to other state associations, Ricci says.

More recently, the POA House of Delegates passed a resolution to “develop and implement a statewide program designed to enhance opportunities for children to have access to quality eye care thereby improving their quality of life.” That resolution, adopted in 2019, spun off into new and significant initiatives, including the CVCA. To join the alliance online or in person, doctors of optometry must agree to:

• Provide expedient and accessible scheduling for all children.
• Promote the alliance with other eye care and health care professionals.
• Communicate the results of the child's eye examination to the respective parents, school nurses and health care professionals involved in the care of the child as appropriate.
• Follow the optometric standards set forth in the AOA’s evidence-based clinical practice guidelines. “It’s an evidence-based reference for doctors of optometry and a credible source to back up the statements we’re making to parents, educators, legislators and other health care providers,” Dr. Sepich says of the pediatric clinical practice guideline.

“In order to do something for the children, we need to hold ourselves to the highest standards of pediatric eye care,” Dr. Savarno says. “The pediatric guideline represents those high standards.”

Further, in the 2019-20 session of the General Assembly, doctors of optometry were asked to urge their local representatives to support a bill, with state Rep. David Zimmerman, R-99th District, as primary sponsor, that required students undergo comprehensive eye examinations at significant developmental milestones, including upon admission to school, in the fourth and eighth grades and when the student is recommended for a skills improvement program. The association expects the legislation, which had 34 sponsors when the last session ended, to be reintroduced during the 2021 legislative session.

Lastly, when school buildings shuttered by COVID-19 reopen, the affiliate hopes to resume its direct outreach to schools.

“We want to reduce the barriers to comprehensive children’s eye exams,” Dr. Sepich says. “We want to make it as easy as possible for parents to bring their children in.

“It’s really about cooperation between us and the educators, school nurse, parents, the pediatrician and family physician of the child,” she says.

Seeing the impact

Undiagnosed and unchecked eye conditions in children may impact their school performance, social interactions and self-esteem into adulthood, POA’s members say.

Dr. Sepich, who has been practicing for 30 years, is being “overrun” with children and college students. Convergence insufficiency is an increasingly common diagnosis at her practice, which provides vision therapy services.

“Keep in mind these college students in their 20s were kids who weren’t diagnosed when they were in grade school or high school,” she says. “Now they are in college and having to work even harder with their eyes and all their underlying troubles are becoming more problematic.

“One of the things we talk about when we are out promoting the need for children’s vision is that if we can address their vision problem early in life and if we can keep them from having to go into special education or special reading classes, the odds of them doing better in life, the odds of them having a better-paying job, skyrocket,” she says.

Says Dr. Umlauf: “It amazes me how primary education puts an emphasis on children’s general health and dental care but not vision. I have seen too much latent hyperopia in my over 30 years of practice.”