The Need for Vision Care of Young Children

• Each year more than 100,000 American children go blind needlessly, simply because they did not receive an eye exam.
• One in 4 elementary school children have an undetected eye problem that may affect learning.
• Timing is critical for proper eye-brain development.
• If these problems are not detected and treated, vision may be lost forever.
• Approximately 5% of children under 5 are at risk for serious vision problems causing permanent vision loss.
• An additional 10% need glasses to have the vision necessary to succeed in school.
• Vision disorders are the most prevalent class of handicapping conditions in childhood.
• Fewer than 15% of all preschool children receive eye exams.
• Fewer than 22% of preschool children receive some type of vision screening to see if they need glasses.
• Amblyopia ("lazy eye"), strabismus (crossed eyes) and significant refractive error (nearsighted, farsighted, & astigmatism) are the prevalent and significant vision disorders of preschool children.

It is well known that identification and treatment of eye abnormalities in childhood are major public health problems in the United States. There are various factors responsible for this problem.

First, there have been no satisfactory methods of identifying these eye abnormalities especially in the first 5 years of life. Although pediatric health care professionals have been trained in rudimentary eye screening methods, they rarely carry out these examinations in young children. Even when they do, their examinations have been shown to have poor accuracy.

Despite the best intentions, current programs are unable to systematically assure that preschool children have the vision they need to succeed in school. Barriers include working parents; transportation problems to appointments for follow-up exams and glasses; language; lack of skilled eye care providers for very young children; care providers (e.g. teachers, parents, healthcare providers, etc.) who are overwhelmed by multiple responsibilities; lack of information about eye care; excessive waits for appointments; provision of substandard glasses (not shatterproof); and lack of follow-up to assure that the child is wearing glasses. Current restrictions of government insurance make billing for EyeMobile services complex and prohibitively expensive to administer.

In our successful work, we found a 35% unmet need for eyeglasses in preschool children referred for eye exams on the EyeMobile. We provided glasses for these children with the support of the San Diego Host Lions Club. In addition to those who needed glasses, we found over 600 children with previously undetected problems such as cataracts, strabismus, nystagmus, and amblyopia, and provided them with the needed referrals for specialist care.