Back To School And Looking Cool? Are Vision Screenings Just As Good As An Eye Exam?

Dr. Mark J. Page, Optometrist and founder of Arizona’s Vision Eye Care Center talks about the right and wrong things parents do when getting their kids ready for back to school.

Kristina Jacobs: Hi Dr. Page, right now all of the schools are getting back in session. A lot of parents are buying school supplies and clothes and various electronic devices like phones, tablets and computers for their kids, possibly for the very first time, and a lot of them think their school will do a screening to check the status of their eyes. Would that be adequate to just let the school do the “eye exam” or their pediatrician instead of the parents taking them to the eye doctor for an eye exam?

Dr. Page: “I would say, definitely not. Parents should know that studies have found that up to 11 percent of children who pass a vision screening actually have a vision problem that needs treatment. Also, children who fail vision screenings often don’t get the vision care they need. Two studies published by the American Academy of Ophthalmology found that 40 to 67 percent of children who fail a vision screening do not receive the recommended follow-up care by an eye doctor. One reason for this lack of compliance is poor communication with parents who may or may not be present at the screening. One study found that two months later, 50 percent of parents were unaware their child had failed a vision screening. The best way to make sure your child has the visual skills he needs to excel in and outside the classroom is to schedule routine comprehensive eye exams with an eye doctor who specializes in children’s vision. Eye exams performed by an eye doctor are the only way to diagnose eye and vision diseases and disorders in children. Undiagnosed vision problems can impair learning and cause vision loss and other issues that significantly impact a child’s quality of life.”

Kristina Jacobs: Well what if a child already sees 20/20. Is there any reason they would need to go for an eye exam?

Dr. Page: “Absolutely! Some children may be farsighted, which means they can see things clear far away. Young children still have a very powerful focusing mechanism inside their eyes. They maybe able to see the 20/20 letters and read the fine print, but the amount of effort their muscles inside the eyes exert can lead to eye strain, headaches, even make it harder to pay attention, or similar to Attention Deficit Disorder. Now another potential problem that could be happening even with 20/20 vision is an increase in the pressure inside the eye. If too much pressure builds up it can begin to crush the optic nerve that connects the eye to the brain. Unfortunately, the optic nerve does not have any pain receptors; it only has fibers that conduct vision. Damage to the optic nerve can be caused by Glaucoma. Now it is not common in kids, but glaucoma can strike anyone at any age. My office referred a 5 year old patient to the glaucoma specialists, and unfortunately, it was too late. He was probably born with glaucoma, but did not have an eye exam until later. At age 7 ½ he lost 100% of his eye sight. We don’t want that to happen to any other kids.”

Kristina Jacobs: Wow, that is a sad story. Are they any other things parents should do or be on the lookout to help protect their child’s eyes?

Dr. Page: “Yes, eye doctors are also growing increasingly concerned about the kinds of light every day electronic devices give off called high-energy visible light which is a short wavelength blue and violet light- and how these rays might affect and even age the eyes. Today’s smartphone, tablets, LED monitors, flat screen TV’s and even the new energy efficient light bulbs all give off light in this range. Early research shows that overexposure to blue light could contribute to eye strain and discomfort, and may lead to serious conditions such as age-related macular degeneration(AMD) which can cause blindness. One of the other side effects that may occur if children use the devices after dark is a delay in the onset of melatonin. Melatonin is one of the hormones that helps us go to sleep. The Harvard Health Letter did a study on the people who work the night shift and found that melatonin was significantly reduced. The study found that over exposure to blue light could also lead to obesity, diabetes and even cancer. They recommended special glasses to filter out the blue light to reduce the risk of those diseases.”

Kristina Jacobs: Okay, so let me ask you this; is it okay to just take kids to any eye doctor? Do they all know about this high energy visible light? Will they be able to prescribe the appropriate glasses that have extra protection?

Dr. Page: “Unfortunately not all eye doctors are aware of this. Most eye doctors do not have any way to determine how much energy or radiation is getting through the glasses. Parents should definitely call around and ask if the doctor prescribes for high energy visible light or HEV protection. Some doctors may cost more, but it is your child and their eyesight. They are worth it. I recommend every child have an eye exam soon after 6 months of age and before age 3. Children now have the benefit of the yearly comprehensive eye exam thanks to the Pediatric Essential Health Benefit in the Affordable Care Act, through age 18. So cost should not be as much of a factor. Just make sure you are going to someone that has experience working with kids. They should also have instruments to be able to measure the amount of protection in your eyeglasses and sunglasses.”

Kristina Jacobs: So that brings up a very interesting point, don’t all eye doctors have instruments to measure the amount of protection in your eyeglasses and sunglasses? Isn’t there some type of law that says they have to have a certain amount of protection?

Dr. Page: “That is a great question. There is no law on the accuracy of the prescription or on the amount of protection. There are recommended guidelines. Studies have been done to measure the amount of UV radiation passing through sunglasses, and about 20% did not match the label. In most cases they were the real inexpensive ones that performed the lowest, but there were also several for high end, high cost sunglasses that also did not match the protection promised on the label. That is why I decided to purchase a high quality UV and visible light transmission meter. We can measure all the lenses that we prescribe to make sure the protection is really there. When you look at the ones that don’t have it they look the same. That is one of the challenging things about educating patients about the differences in lens quality. Most of it is easily apparent. Kind of like different types of cameras. They all take pictures, but some have higher resolution and give better details than others.”

Kristina Jacobs: Let me ask you this one final question if I could. What is the one thing you feel someone must consider in deciding where to spend their money when they need to take their kids to have their eyes examined, or themselves for that matter? What’s the one thing they should focus on?

Dr. Page: “I would try to keep it as simple as possible. Do they have a good reputation. Are they well known in the community, have they been around for at least a couple of years? You can also ask your doctor or pediatrician to recommend professionals that they trust. You just want to make sure they do have some experience with treating kids. It helps if they also have little treats or a treasure chest to help make it a fun experience for your child. Our eyesight if a very precious gift. We want to try and make sure we can see until the day we die. If kids have a good experience from the start it will help make going again and again in the future a little easier.”

Kristina Jacobs: That’s fantastic, the things that most people really don’t think about. Those are really simple and inexpensive things. Like you said earlier it seems like you are getting eye exam when they do a vision screening, but now I realize a whole lot is being missed and that could affect your child for the rest of their life. I certainly appreciate the frankness about what screenings can do and what they can’t do and I know that’s why you have such a great reputation with your patients is because you talk with them about things that you can’t necessarily see. I appreciate you sharing that with us today.

Dr. Mark J. Page, Optometrist is the founder of Arizona’s Vision in Phoenix Arizona and he is also the founder and creator of Invisalens, “the braces for your eyes”. Primarily working with families and kids, Dr. Page grew Arizona’s Vision to the #1 Orthokeratology practice in the greater Phoenix area. Voted America’s Top Optometrist, Voted Best of Optometrist by the Ahwatukee Foothills News. Author of the upcoming book: The Smart Parents Guide: How NOT To Ruin Your Child’s Eyes. He attributes that success to his commitment and dedication to his family’s and his patient’s quest to see what they’ve been missing.

You can find out more about Dr. Page and Arizona’s Vision at http://AZglasses.com.

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