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No Kidding
Kids may get short shrift if ophthalmology has its way with legislation aimed at full exams.
FROM THE EXECUTIVE EDITOR
LARISA HUBBS

Comprehensive vision exams for children hardly seems like a controversial issue. Yet, in the seven states that have introduced legislation spearheaded by optometry, ophthalmologists and pediatricians have donned their full armor.

A look at the legislation

The legislation specifies that children would need a comprehensive vision exam before entering school.

The state departments of education would enforce the bills, which are under consideration in California, Connecticut, Massachusetts, Missouri, Ohio and Wisconsin. The only state that has passed this into law is Kentucky, which did so in 2000.

Definite need

According to the Vision Council of America (VCA), which is helping states initiate this legislation, there's a huge need for these efforts.

"Roughly 80% of all learning during a child's first 12 years is obtained through vision, yet 10% of all preschoolers and 25% of students in grades K through 6 -- that's one out of every four students -- have vision deficiencies," according to VCA's literature on the matter.

So what's the problem?

Screenings are enough

According to several sources in states where these bills are in play, the main reason ophthalmologists and pediatricians are fighting these bills is that they believe the vision screenings children receive from pediatricians are adequate and that optometrists are mainly supporting this legislation as a way to acquire more patients.

The editorial board of the Hartford (Connecticut) Courant recently devoted a lot of ink to the issue, coming down soundly on the M.D.s' side.

The heavy-handed piece, titled "The Legislature's Blurred Vision," was based on position statements from Connecticut ophthalmologists and pediatricians. No optometrists were contacted.

Some main points are as follows:

• critics of the bill refer to it as the "optometrists' full-employment act."
• youngsters would be forced to get screened for eye problems that are either rare or that typically don't appear until adolescence or adulthood.
• ". . . some of the tests specified in the bill are inappropriate for youngsters." The editorial specifies tonometry and explains that children often need sedation to undergo this test.

Unexpected benefit

Instead of serving to quash support for these vision bills, ophthalmology's opposition seems to be having the reverse effect.

"I haven't seen an issue since TPAs that has created this level of enthusiasm and common purpose in optometry," says Dr. Jim Thimons, who helped with the Connecticut bill.

Adds Dr. Thimons, "the bill is looking good so far in our state."