Children’s Eye Health and Safety Month is a timely reminder to prepare our children for the classroom and athletics. A good rule of thumb is to have your children’s eyes examined during well-child visits, beginning around age three. This blog will cover Vision Screenings vs Eye Exams, Blue Light and Your Eyes, and resources for Financial Assistance. Information in each section was found on the Prevent Blindness Website with direct links to specific articles linked in each heading.
Both vision screenings and eye examinations may play an important role in your child’s vision and eye health, so it’s important to understand their distinctions.
An eye exam is performed by an eye doctor (ophthalmologist or optometrist). An exam diagnoses eye disorders and diseases and prescribes treatment. A comprehensive eye examination is generally understood to include an evaluation of the refractive state, dilated fundus examination, visual acuity, ocular alignment, binocularity, and color vision testing where appropriate.
A vision screening is not a diagnostic process and does not replace a comprehensive examination by an eye doctor. The purpose of a vision screening is to identify vision problems in a treatable stage, provide education, and provide a referral to an eye care provider for a comprehensive eye exam (if needed). These screenings should be routinely done by your child’s medical doctor (and may also be conducted in your child’s preschool, school, or other community settings).
Vision screening identifies asymptomatic children with possible vision deficits who, then, require a comprehensive eye examination for diagnosis and treatment. Certain children should bypass vision screening and, instead, be referred directly to an optometrist or ophthalmologist for a comprehensive eye examination because these children have a higher rate of vision problems.
Children who should bypass vision screening include those with:
· Readily recognized eye abnormalities, such as strabismus (cross eyed) or ptosis (drooping of the eyelid).
· A known diagnosis of a neurodevelopmental disorder (e.g., hearing impairment, motor abnormalities such as cerebral palsy, cognitive impairment, autism spectrum disorders, or speech delay).
· Systemic diseases known to have associated eye disorders (e.g., diabetes and juvenile rheumatoid arthritis).
· A known family history of a first-degree relative with strabismus (cross-eyed), amblyopia (lazy eye), or high refractive error.
· A history of premature birth and low birthweight (<31 weeks and 1,500 grams/3.3 pounds birthweight) who has not already had a normal comprehensive eye examination.
· Parents (or caregivers) who believe their child has a vision-related problem or have concerns regarding their child’s reaching age-appropriate developmental or academic milestones.
* Note, where specific state protocols exist, screeners should follow those guidelines for screening children as part of the Individualized Education Program process.
Sunlight is made up of red, orange, yellow, green, blue, indigo, and violet light. When combined, it becomes the white light we see. Each of these has a different energy and wavelength. Rays on the red end have longer wavelengths and less energy. On the other end, blue rays have shorter wavelengths and more energy. Light that looks white can have a large blue component, which can expose the eye to a higher amount of wavelength from the blue end of the spectrum.
The largest source of blue light is sunlight. In addition, there are many other sources:
• Fluorescent light
• CFL (compact fluorescent light) bulbs
• LED light
• Flat screen LED televisions
• Computer monitors, smart phones, and tablet screens
Blue light exposure you receive from screens is small compared to the amount of exposure from the sun. And yet, there is concern over the long-term effects of screen exposure because of the close proximity of the screens and the length of time spent looking at them. According to a recent NEI-funded study, children’s eyes absorb more blue light than adults from digital device screens.
Blue light is needed, however, for good health:
• It boosts alertness, helps memory and cognitive function, and elevates mood.
• It regulates circadian rhythm – the body’s natural wake and sleep cycle. Exposure to blue light during daytime hours helps maintain a healthful circadian rhythm. Too much exposure to blue light late at night (through smart phones, tablets, and computers) can disturb the wake and sleep cycle, leading to problems sleeping and daytime tiredness.
• Not enough exposure to sunlight in children could affect the growth and development of their eyes and vision. Early studies show a deficiency in blue light exposure could contribute to the recent increase in myopia/nearsightedness.
If constant exposure to blue light from smart phones, tablets, and computer screens is an issue, there are a few ways to decrease exposure to blue light:
Filters: Screen filters are available for smart phones, tablets, and computer screens. They decrease the amount of blue light given off from these devices that could reach the retina in our eyes.
Computer glasses: Computer glasses with yellow tinted lenses that block blue light can help ease computer digital eye strain by increasing contrast.
Anti-reflective lenses: Anti-reflective lenses reduce glare and increase contrast and also block blue light from the sun and digital devices.
There are many available resources for obtaining financial assistance when it comes to eye exams and procedures. The following are just a few examples that offer such assistance to persons under the age of 18. These resources are in addition to the most known options of Medicaid and Medicare.
The HealthWell Foundation: The HealthWell Foundation provides financial assistance to eligible individuals to cover co-insurance, copayments, healthcare premiums and deductibles for certain treatments. Phone: (800) 675-8416 Fax: (800) 282-7692 www.healthwellfoundation.org
The Hill Burton Program: Participating hospitals and other healthcare facilities provide medical care for free, or at reduced cost, to those who meet eligibility requirements based on family size and income. Procedures covered vary from hospital to hospital. A list of assisting sites available in your state is located online. Phone: (800) 492-0359 (Maryland residents) (800) 638-0742 www.hrsa.gov/get-health-care/affordable/hill-burton/index.html
InfantSEE: InfantSEE optometrists provide a no-cost comprehensive eye and vision assessment for infants within the first year of life regardless of a family’s income or access to insurance coverage. Phone: (888) 396-EYES (3937) www.infantsee.org
Lions Clubs International: Provides financial assistance to individuals for eye care through local clubs. On their website, go to “Club Locator” to locate your local club. Phone: (630) 571-5466 or (800) 747-4448 www.lionsclubs.org
National Federation of the Blind: NFB works to improve social and economic conditions of blind persons by providing evaluations of present programs and assistance in establishing new ones; awards scholarships to blind persons; has a public education program including speakers’ bureau; and has several special interest divisions, including those for diabetics, educators, lawyers, parents of blind children, students and public employees. The National Federation of the Blind has affiliates in all fifty states plus Washington D.C. and Puerto Rico, and over seven hundred local chapters. Phone: (410) 659-9314 www.nfb.org
New Eyes for the Needy: New Eyes provides a basic pair of single or lined bifocal lenses. A New Eyes voucher is for individuals who have no other resources with which to obtain a basic pair of eyeglasses. Applicants must have an eye exam including their pupillary distance (PD) measurement before applying. Phone: (973) 376-4903 Fax: (973) 376-3807 www.new-eyes.org
VSP® Eyes of Hope®, Sight for Students®, and Eyes of Hope® Materials Only: VSP® Eyes of Hope® and Sight for Students gift certificates provide adults and children in need (families’ income is at or below 200% of the federal poverty level) with access to eye care and new glasses (if needed) at no cost through a VSP network doctor in their community. VSP® Eyes of Hope® Materials Only gift certificates provide individuals who have coverage for an eye exam but not eyewear with no-cost prescription glasses. Contact your local Prevent Blindness affiliate or Prevent Blindness for more details. Phone: (800) 877-7195 https://vspglobal.com/cms/vspglobal-outreach/gift-certificates.html