A complete physical exam where your health care provider will check your child’s growth and development in order to find or prevent problems. Hearing, vision, and other screening tests will be part of some visits. Even if your child is healthy, well-child visits are a good time to focus on your child’s wellness.
The absence of vision, or a loss of vision that can’t be corrected with glasses or contact lenses.
A measure of how well a child sees. “Normal” vision is 20/20. This means that a child sees the same line of letters at 20 feet that a child with normal vision sees at 20 feet. 20/40 vision means a child sees at 20 feet what a child with normal vision sees at 40 feet.
The ability to move the eyes from left to right or focus on an object as it moves across a child’s visual field. This skill typically develops by age five and is important for all daily activities, including playing, reading, writing, and drawing.
Vision exercises prescribed by some optometrists to improve visual skills and abilities.
The set of 10 categories of services that health insurance plans must cover under the Affordable Care Act.
Also called “cross eyes,” is any misalignment of the eyes, and can be a cause of amblyopia.
Ability of both eyes to see the same object as one image and to create a perception of depth. It is a measure of how well both eyes work together. Also known as stereoscopic depth perception.
A special tool used by eye doctors to get a magnified look at parts of the eye.
A tool used by eye doctors during an eye examination to determine refractive error by shining light into the eye to observe the reflection of light off the retina (back of the eye). A retinoscope is especially useful in young children who can’t look through a refractor.
A thin layer of tissue that lines the inside of the back of the eye located near the optic nerve. The retina is responsible for converting light from the eye lens into signals that are sent to the brain for visual recognition.
Also called a “phoropter,” refers to a vision testing device with multiple lenses that a child looks through to measure the refractive error and determine the need for an eyeglass prescription. It is commonly used by eye doctors during an eye examination for older children.
Vision conditions that occur when light rays from an object don’t focus on the back of the eye (retina) properly. Refractive errors include myopia, hyperopia and astigmatism. Refractive errors are the most common vision problems in children.
How light from an object bends as it passes through the eye to focus on the retina.
When a student has mastered the reading age/grade level expectations. A child’s reading proficiency by third grade is the most important predictor of high school and career success.
Enlarging the pupil (dark part of the eye) with special eye drops to allow eye doctors to examine the inside of the eye and make a more accurate diagnosis. After having pupils dilated, children may have light sensitivity and blurry vision for a brief period. Sunglasses can help with the light sensitivity. Children can return to school after having their eyes dilated, but the teacher should be notified of the blurred vision side effect.
Also called “autorefractor”refers to a specialized camera that takes pictures of the eyes. It is used to provide vision screening for young children age 5 and under.
Everything that is seen outside the central area of focus, including side vision.
Doctor of optometry (OD) who examines eyes for both vision and health problems, and prescribes corrective lenses for children.
Doctor of Optometry (MD) who has additional special training to examine eyes for both vision and health problems, and prescribes corrective lenses for children.
An instrument used by doctors for inspecting the inside of an eye.
Doctor of optometry (OD) who examines eyes for both vision and health problems, and prescribes corrective lenses.
Medical doctor (MD) who spectializes in eye and vision care. Ophthalmologists are trained to perform eye exams, diagnose and treat disease, prescribe medication and corrective lenses as well as perform eye surgery.
A condition also known as “nearsightedness” that causes distant objects to appear blurry and objects up close to appear normal. It occurs when visual images come to focus in front of, instead of on the top of the retina of the eye.
A government health insurance program for qualifying low-income individuals. AHCCCS is the agency in Arizona responsible for administering Medicaid.
An AHCCCS program that provides health care coverage to children under age 19. KidsCare is for children who do not have health insurance and do not qualify for Medicaid. Families must pay a monthly premium.
A condition also known as “farsightedness” that causes near objects to appear blurry and distant objects to appear normal. It occurs when images come to focus behind, instead of on top of the retina of the eye.
The ability to see the world in three dimensions (3D) and the distance of an object.
The inability to see all colors. Usually a child with color blindness can see some colors but not others and often do not know he/she sees colors differently. Eye doctors can test a child for color blindness by asking him/her to name pictures with patterns of colored dots. A child with color blindness will not see some of the patterns.
The ability to see all colors.
Also called “photoscreener,” refers to a specialized camera that takes pictures of the eyes. It is used to provide vision screening for young children age 5 and under.
Blurry vision at all distances caused by irregularity in the shape of the cornea or lens of the eye.
Also called “lazy eye,” refers to decreased vision in an eye that otherwise appears normal. Occurs as a result of the connections between the eye and brain not working well.
The Arizona Health Care Cost Containment System (AHCCCS), which oversees the Arizona Medicaid program that provides health care coverage for qualified participants. Vision services are covered for free for AHCCCS recipients under age 21.
Across the world, researchers have documented that children are developing nearsightedness (myopia) at younger ages. One study found that nearly 30 percent of children ages 11 to 13 have myopia, and more than a third of those children have not received corrective lenses. Researchers found that for every extra hour of outdoor time spent per week, the relative risk of a child developing myopia drops by nearly 15 percent. Read More
Could the persistent gap in reading performance between poor students and wealthier ones be closed if poor students were given eyeglasses? Researchers that found that reading proficiency improved significantly for second and third graders who were given eyeglasses compared with the children who did not need them. Armed with these research findings, Vision for Baltimore, a mobile vision clinic began visiting to schools across Baltimore to provide free screenings and eyeglasses.Read More
The Gift of Sight and Sound Program offers a school-based optometry clinic for children referred to an optometrist, and a school-based dispensing clinic for dispensing prescribed glasses. The program was able to track outcomes for more than 90 percent of the children that were referred for further assessment. Four of every five students who went to these clinics needed and received glasses. Read More
Studies indicate that increasing the time spent outdoors significantly reduces myopia and its progression. For every additional hour of time spent outdoors per week, the odds of developing myopia decrease by 2 percent. Increasing time spent outdoors may be a simple strategy to reduce the risk of children and adolescents developing myopia.Read More
The largest study of childhood eye diseases ever undertaken in the U.S. confirms that that the incidence of childhood myopia among American children has more than doubled over the last 50 years. The rise in screen-related activities, coupled with a decrease in exposure to outdoor light, is damaging children’s vision.
Researchers have investigated how vision can affect a child’s ongoing learning, with results showing 30 percent of third grade students tested had uncorrected eye problems that could affect academic performances. Children referred at vision screening scored lower on literacy and numeracy tests. Vision screening could thus identify children who may be at risk of underachieving. Read More
Uncorrected farsightedness (hyperopia) in preschool children is associated with significantly worse performance on a test of early literacy. Results of the study, which compared 4- and 5-year-old children with uncorrected hyperopia to children with normal vision, found that children with moderate hyperopia did significantly worse on the Test of Preschool Early Literacy (TOPEL) than peers with normal vision. This study demonstrated that vision related problems that make it harder for children to see things up-close affect grade school readiness. Read More
Researchers have investigated how vision can affect a child’s ongoing learning, with results showing 30 percent of third-grade students tested had uncorrected eye problems that could affect academic performances. Children referred at vision screening scored lower on literacy and numeracy tests. Vision screening could thus identify children who may be at risk of underachieving.
Uncorrected farsightedness (hyperopia) in preschool children is associated with significantly worse performance on a test of early literacy. Results of the study, which compared 4- and 5-year-old children with uncorrected hyperopia to children with normal vision, found that children with moderate hyperopia did significantly worse on the Test of Preschool Early Literacy (TOPEL) than peers with normal vision. This study demonstrated that vision-related problems that make it harder for children to see things up-close affect grade school readiness.
“When NICHQ asked me to be a part of the quality improvement team, I was eager to join. It seemed that this team had a methodical, realistic way to help other families, and that has become my passion,” says Heather Joy Magdelano, a parent partner on NICHQ’s Improving Children’s Vision project.
Parents of children with special health needs become experts on their children’s condition in a way that doctors and administrators cannot. Their countless hours on the front line, navigating the healthcare system and other community resources, gives them invaluable insight into how these systems work (and do not work) for them. That is why NICHQ emphasizes the value of utilizing the parent/family perspectives in change efforts.
“We make it a point to have at least one family representative, usually a parent, on each of our project teams,” says NICHQ Director of Programs Meghan Johnson, MSc. “Their perspectives, opinions and ideas help ensure that the team creates improvements that will work ‘in the real world’. Too often patients and families have ideas on how to improve the health system, but there is nowhere to share or implement them.”
Heather Joy Magdelano is a parent partner on NICHQ’s Improving Children’s Vision project. She has two deaf and blind children and is a leader in advocating for families with deaf and/or blind children. Both of Magdelano’s children have a rare genetic syndrome diagnosed at birth, yet the oldest was not diagnosed with a vision problem until he was five months old.
“Most pediatricians do not check for vision problems at such a young age,” says Magdelano. “If you are concerned, you may have to push to get vision checked, but you should because early intervention is critical.”
Magdelano received news of her son’s vision problem by a call from the Foundation for Blind Children.
“I was more than surprised to receive this call out of the blue. No one from my pediatrician’s office had talked to me about vision problems,” she recalls, as well as feeling validated, as she knew something was not quite right but did not know what it was.
Magdelano’s son has cortical vision impairment where the brain does not process what the eyes see. It often goes undiagnosed. After needing to advocate for her own children, Magdelano says she did not want others to go through what she had experienced.
“When NICHQ asked me to be a part of the quality improvement team, I was eager to join. It seemed that this team had a methodical, realistic way to help other families, and that has become my passion,” says Magdelano.
Magdelano is a perfect example of what NICHQ looks for when recruiting parent partners. According to Johnson, it’s best to look for family members who are passionate about the subject matter and ready to share their experience and advocate for others.
“A family partner is not just a token or a nice to have,” says Johnson. “They are equal members of the team. Their lived experience is just as important as that of the medical, quality and administrative experts.”
Family partners often change the trajectory of a proposed improvement idea, making it more successful. For example, Johnson recounted an instance when a NICHQ team was working on a tool for families to communicate outcomes on a daily basis. An online daily survey was proposed. However, the two family partners pointed out that it was difficult or impossible to get online daily to do this. Some didn’t have a smart phone or a computer, others didn’t have the time to log on and fill out the survey. One family partner suggested that families text their answers to the team. To try out the idea, the improvement team bought inexpensive phones for those who needed texting capability. It worked! More people communicated outcomes, which of course informed the project and made it more successful.
In another example, Magdelano’s team was attempting to create a letter that pediatricians could give to families, recommending that they see an optometrist. The two parent partners had very different views on the letter’s language. This reinforces the importance of remembering that one or two parent partners do not necessarily represent the views of all parents. These parent partners decided to run the language by their friends who had children with the same condition, but were not part of the team. In the end, family members on and off the team were instrumental in designing the letter. In turn, the letter will help more families obtain vision testing which is often overlooked.
There are some barriers to engaging family partners on quality improvement teams. Attendance is at the top of the list and is influenced by lack of time, funds, transportation, childcare and scheduling.
“We need to do everything we can to avail ourselves of family members’ perspectives so that we can make real, sustainable change,” says Johnson. “This means scheduling meetings around family partners’ schedules, providing childcare, using technology to hold virtual meetings when necessary, and even paying family partners.”
Magdelano suggests that teams help keep family partners engaged by sending them notes from the meeting and having the team leader call to catch up. “Calls are important,” says Magdelano. “There is so much more communicated through talking to someone versus reading notes.”
Magdelano reports myriad benefits for her and the community just by being a part of the NICHQ team.
“I have never been in a quality improvement process and it is interesting to see the issues from this perspective,” she says. “It got me to step out of my box and think in a different way. It also helped me see where a quality perspective could be beneficial in other community organizations.”