The Chicago Tribune’s editorial staff is in the dark.

Opinions squawked on August 19, 2008, “We do not need another nanny-state mandate.” As luck would have it, my upbeat “Letter to the Editor” was also posted on-line August 19, 2008 in response the Tribune’s story, Not seeing eye to eye.

The Tribune does not see anything good about this new eye exam law. Here are my “Top Ten Disputes” followed by the “Top Ten References.”

Look again, Chicago Tribune. I just turned the light on…

Top Ten Disputes:

10. Eye exams are a “huge waste of time and money for the other 90 percent.” Let’s be fair…then health exams are a huge waste of time and money for healthy kids.

9. “The state already requires in-school screenings in kindergarten and 2nd and 8th grades.” Don’t get me started about the state’s screening program.

8. “Many pediatricians routinely include vision screenings as part of a regular physical.” Maybe they should check the teeth, too, while they’re at it.

7. “Such screenings aren’t as thorough, but they’re a cost-effective way to sort the kids who might need a comprehensive exam from the overwhelming majority who don’t.” A cost effective way to sort the kids? I don’t want my child sorted. Did you know an MD or pediatrician can bill a vision screening as an exam?

6. “That’s why groups including the American Academy of Pediatrics (AAP) and the American Academy of Ophthalmology (AAO) oppose mandatory eye exams for children.” I wish the AAP and AAO would oppose required calculators. I had to buy a $140 TI-84+ graphing calculator for my 7th grader. Groups that oppose mandatory exams have a hidden agenda that is NOT in the best interests of kids. Beware.

5. “Besides out-of-pocket costs, we’ll be paying for those exams in the form of higher premiums—and more tax dollars to cover the costs for those who rely on the government for medical care.” My son’s kindergarten well-child visit, shots, and blood work cost a whopping $629 in 2006. His eye exam? $61. Something isn’t adding up here…

4. “A 2004 study published in the Journal of the American Academy of Pediatric Ophthalmology and Strabismus concluded that mandatory eye exams can lead to wasteful overprescribing of glasses.” I bet it was a tainted study. Did you know ophthalmologists (OMDs) practice optometry by exemption? Perhaps the OMD should be included in the optometric licensing and continuing-ed (CE) requirements.

3. “Educators aren’t thrilled about having to enforce yet another nanny-state law.” Here we go again…nanny-state law. I think someone is watching too much Super Nanny, Take Home Nanny, and Nanny 911.

2. “But schools still bear the administrative burden, along with the thankless task of nagging noncompliant parents.” Nagging noncompliant parents? I’m calling Jon Stossel. Give me a break!

1. “What’s coming into focus is an overreaching law that burdens parents and educators and drives up the cost of medical care. There are no proven benefits and no consequences for those who blow it off.” No consequences? There are consequences. Here is one example.

Top Ten References:

10. “Vision disorders are the most prevalent handicapping condition in childhood. However, fewer than 15% of all preschool children receive an eye examination.” (National Eye Institute, 2/14/06) This is serious.

9. “Important vision disorders in children include amblyopia, strabismus, significant refractive error, ocular disease, and color vision deficits. Early detection and treatment of these disorders are important to maximize a child’s visual potential.” (Survey of Ophthalmology, March/April 1999, page 445) Do you believe the authors missed convergence insufficiency and learning related vision problems?

8. “Amblyopia is a significant public health problem, with a prevalence in the neighborhood of 2% to 5%. It is the leading cause of monocular blindness in the 20-70 year age group.” (Ophthalmology 2000, page 1637) Again, this is serious.

7. “Early detection of amblyopia can occur if factors that cause amblyopia are detected and treated earlier, possibly even before children become literate.” (Ophthalmology 2000, page 1637) Let’s catch this early before it’s too late.

6. “Visual development from birth through school age has sensitive and critical periods where abnormalities can lead to permanent impairments, especially in the development of binocular vision, an important part of human vision.” (American Public Health Association, Policy Statement 2001-1) Eye exams are important.

5. “Impaired vision in children can seriously impede learning and contributes to the development of emotional and behavioral problems. Early discovery and treatment can prevent or at least alleviate many of these problems.” (Illinois Department of Public Health, Vision Screening Manual, July 2001) This is from the Department of Public Health.

4. “Screening is NOT a diagnostic procedure and does NOT determine that correction of a possible defect or need for glasses is indicated. Diagnoses are made only by an eye doctor.” (Illinois Department of Public Health, Vision Screening Manual, July 2001) This is exactly how it is printed in the manual. In other words, screenings don’t do anything.

3. “Screening tests vary widely in performance, even when administered by licensed eye care professionals. The four best tests detected two-thirds of children with one or more targeted conditions, but nearly 90% of the children with the most severe conditions.” (National Eye Institute, 2/14/06) 68% = F, and for the most severe cases 90% = B? What if your child was missed?

2. “Vision screening is not a substitute for a complete eye and vision evaluation by an eye doctor.” (Illinois Public Act 93-0504) The public has been fooled for too long.

1. “Children with impaired vision often are not aware of their handicap; therefore, they do not complain or seek help. If they have always seen in a blurred or distorted way, they accept the imperfect image without question. For this reason, it is up to the adults responsible for the child’s health care and educational process to detect those children with vision problems.” (Illinois Department of Public Health, Vision Screening Manual, July 2001) Look at the children, looking up to us, to look out for them…

In 1969, Illinois began mandating vision screenings by lay people who would be certified after a three-day-class for $100. Almost 40 years later, we’re still doing the same thing, except Illinois lawmakers raised the standards for all children starting kindergarten in 2008.

Two choices are available: be a part of the problem, or be a part of the solution. What is your choice going to be?

Copyright (c) 2008 Vision First Foundation. All rights reserved.