When Janet Hughes of Lemont prepared her daughter, Amy, for kindergarten in 2001, she followed everything in the school’s registration packet — vaccinations, a health and dental exam and a long school supply list.
But when Hughes took her daughter for an eye examination the following year, Amy was diagnosed with something her mandated vision screening at school had missed — a high refractive error with large amounts of astigmatism.
“I was shocked,” Hughes said. “My daughter had been working 10 times harder than she needed to because she did not have glasses. If the screening missed my daughter, how many others had it missed?”
Amy’s experiences motivated Hughes to take action. Six years after Amy was diagnosed, Hughes has helped pass Senate Bill 641 into law in Illinois, requiring all incoming kindergarten students in any public, private or parochial school in Illinois to have a eye exam by an eye doctor by Oct. 15, or show proof they will be receiving one within 60 days. Children enrolling for the first time in an Illinois school are also required to have an eye exam.
If students are unable to complete an exam, they must submit a waiver specifying the reasons. If an eye exam is not completed, the district has the right to withhold students’ report cards.
“Learning is 80 percent visual,” Hughes said. “We need to give children the best start we can.”
Eyes count campaign
The passage of Senate Bill 641 into law is only the most recent accomplishment for Hughes.
In 2003, Hughes initiated legislation with Sen. Christine Radogno, 41st District, to warn parents of the failings of vision screenings. Six months later under Senate Bill 805 or Amy’s Law, Illinois became the first state to require a written disclaimer prior to a vision screening stating that a vision screening is not a substitute for a vision examination.
Parents are also given the choice of an eye exam by an eye doctor in place of a mandated vision screening.
In 2004, the Illinois PTA adopted a resolution Hughes helped prepared requiring eye examinations for all incoming kindergarten students. The Illinois Federation of Teachers adopted the same resolution in 2005.
To raise awareness and funds for her Kids Eyes Count Campaign, Hughes founded Vision First Foundation in 2005, a nonprofit organization dedicated to educating parents about need for eye examinations for children and raising funds for eye exams.
Then in Feb. 2007, the IFT initiated legislation with Sen. Deanna Demuzio and Rep. Jil Tracy as the chief sponsors. Senate Bill 641 sailed through the Illinois Legislature.
When Gov. Rod Blagojevich vetoed the bill, the Illinois House and Senate overrode his decision.
Dr. Floyd Mizener, vice president of Vision First Foundation and a retired optometrist, said Illinois has set a precedent for other states to follow.
“The rest of the country is trying to copy us now,” Mizener said. “It’s contagious. People realize children deserve to have proper eye examinations.”
Under the Vision and Hearing Test Act, enacted by Illinois in 1969, mass vision and hearing screenings are required for all children in any public, private, or parochial school. The Illinois Department of Health’s vision screening program heralded vision screenings as the fastest and most economical way of detecting the need of an eye exam by an eye doctor.
Unfortunately, Mizener said, most people assume a vision screening equals a comprehensive vision examination, conducted by an optometrist.
“A vision screener has one day of training,” Mizener said. “An optometrist doing an eye exam has gone to school for eight years. Who would you trust to tell you that your eyes are healthy?”
Suspicious screenings
Vision screenings take place at the Department of Motor Vehicles, at children’s schools and at local health fairs by a vision screener. If the screener suspects an individual has a vision problem, he or she is referred to an eye doctor. Screenings do not assess eye health or diagnose or treat an eye condition.
When patients rely on a vision screening to catch eye and vision problems, Mizener said, too many go undiagnosed.
“Over 50 percent of kids with eye problems are never detected in a vision screening,” Mizener said. “I’ve seen children a thousand times over whose eye conditions were overlooked in a vision screening and by the time they came to see an eye doctor it was too late. Some of these children will be one-eyed forever.”
In 1987, Illinois acknowledged the importance of vision exams. Schools at the local level could require a vision exam with the health exam in grades kindergarten, five, and nine, Hughes and Mizener said. However, few school districts followed its policy.
Early detection
Dr. Sam Forzley of the Forzley Eye Clinic, 1192 Walter St., Lemont, said early appointments give optometrists a chance to check for eye conditions that may go unnoticed.
“Children with eye conditions assume that everyone sees the same way they do,” Forzley said. “Without something to compare their vision to, they don’t think anything is wrong.”
Seventy percent of all children have some kind of corrective need, such as nearsightedness, farsightedness or astigmatism, Forzley said.
“By seeing an image properly, students can grasp concepts and understand the material better,” Forzley said. “An eye condition slows down learning.”
The comprehensive eye exam required goes beyond just checking for vision problems.
“Unfortunately, we use sight as a barometer for our eye health, but this is not the case,” Forzley said. “Vision is just one aspect.”
Forzley said common eye conditions for children are amblyopia, or lazy eye; strabismus, or cross-eyed; and anisometropia, or a large difference in the prescription between the two eyes. If caught early, each condition can be treated and corrected. Forzley said these conditions are treatable until children are 9 or 10.
Although less common, children are also at risk for congenital cataracts and glaucoma. Family history and premature birth put children at increased risk for these conditions.
“I’ve seen children with the same eye diseases that adults have,” Forzley said. “Catching these problems early on will give us a better chance of treating them.”
Facing opposition
Some vision screening advocates believe routine eye exams are a waste of time and money, Hughes said.
“If an eye doctor told me that my children’s’ eyes were fine, I would say, ‘Hallelujah!’” Hughes said. “I have five children, and four of them need glasses.”
Parents worrying about the cost of the appointment could find assistance from Sight for Students or Vision USA. Families covering by federal health care programs already receive free eye exams and free glasses, Hughes said. Seeking out assistance from a local Lions Club chapter is another option for parents.
Mizener said his own efforts to reform the system have faced major opposition in Springfield since the 1950s.
“Vision screeners are concerned they will lose their jobs, and they say optometrists only want to grab more patients,” Mizener said. “Taxpayers’ money goes to ineffective screening programs. When so many children are being missed, something needs to change.”
Blagojevich’s veto of Senate Bill 641 last October makes Hughes wary of the security of the law.
“We’re really excited about the new law, but our work is not done,” Hughes said. “We’re watching the law closely to make sure it is not repealed. Healthy eyes and good vision are a child’s best school supply.”
