Unite For Sight: Eye Health for Teachers

1. Unite For Sight:Eye Health for Teachers <Insert Your Name> Community Fellow, <Insert University>

2. Vision Problems in an Academic Setting • Vision problems affect nearly 13.5 million children in the U.S. • Students, especially young ones, may not know that what they are experiencing is a vision problem • Leads to frustration and worsening academic performance

3. Teachers’ Unique Position • Teachers are in a unique position to notice a child with a vision problem • See children for many hours a day • See children in an academic setting where visual acuity is required

4. The Importance of Discovering Vision Problems Early • Discovering vision problems early on in a child’s life is an important part of helping him or her do well in school. • Avoid frustration • Make reading easier • Make learning more enjoyable • In the case of some vision conditions (covered later), early detection and treatment is the only way to prevent loss of sight in the afflicted eye

5. How to Identify a Child in Need The following may be indicative of a child experiencing a vision problem: • Eyes turning inward or outward • Squinting • Headaches • Worsening academic performance • Blurred or double vision • Losing place while reading • Avoiding close work • Holding reading material closer than normal • Rubbing eyes • Eyes tiring while reading or doing other schoolwork • Turning or tilting head to use one eye only • Making frequent reversals while reading or writing • Using finger to maintain place while reading • Consistently performing below potential

6. How to Identify a Child in Need • If you notice a child struggling with any of these symptoms, he or she may be experiencing a vision problem • The next step is to make sure that child has an eye exam by an eye doctor

7. Vision Screenings vs. Eye Exams Eye Exams • Performed by optometrists or ophthalmologists • Thorough • Can detect many vision problems and/or eye disorders and diagnose them • Vision screenings • (insignificant) • Performed by non-specialist health staff • Provide baseline VA • Do not test for eye disorders, cannot provide diagnostic information

8. Vision Screenings: Frequently Inaccurate • Test only distance visual acuity. • Fail to detect children who have reading problems, hyperopia, or astigmatism. • Vision screenings are subjective • A research study found that two school nurses matched on their vision screening results for only 86.4% of the students. Ore, L., Tamir, A., Stein, N., and Cohen-Dar, M. “Reliability of Vision Screening Tests for School Children.” Journal of Nursing Scholarship. 41.3 (2009): 250-259.

9. Vision Screenings: Test Only Distance Visual Acuity • A study in New York City schools found that 41% of children who passed a distance visual acuity test still needed to be examined by an eye doctor for other reasons. • Screening solely for reduced visual acuity may miss up to 40% with potential vision problems.Bodack, M., Chung, I., and Krumholtz, I. “An Analysis of Vision Screening Data from New York City Public Schools.” Journal of the American Optometric Association. 81.9 (2010); 476-484.

10. Children and Eyeglasses • Do not assume that children with eyeglasses have recently had an eye exam. • A research study found that 49% of eyeglass-wearing children failed a visual assessment. 28% of non-eyeglass-wearing children failed the visual assessment. “Children Unable to Perform Screening Tests in Vision in Preschoolers Study: Proportion with Ocular Conditions and Impact on Measures of Test Accuracy.” Investigative Ophthalmology and Visual Science. 48 (2007):83-87.

11. Reading and Visual Skills • A research study was conducted in California high schools among students who were identified by their teachers as “poor readers”. • 17% of the students had deficient visual acuity (20/40 or worse in one eye) • 80% of the children were inadequate or weak in at least one of the following visual skills: binocular fusion ranges at near, accomodative facility, and convergence near point. • 80% of the students passed the visual acuity testing, but only 20% had adequate visual skills.Grisham, D., Powers, M., and Riles, P. “Visual skills of poor readers in high school.” Journal of the American Optometric Association. 78.10 (2007); 542-549.

12. Getting Free Eye Exams • Visits to an eye doctor can be expensive • Not everyone has health insurance that covers the cost of eye exams • CHIP • Each state has the Children’s Health Insurance Program (CHIP) which can cover the cost of eye exams for children of families that qualify • For information on your state’s program, go to www.insurekidsnow.gov • You can also call (877)-KIDS-NOW

13. Getting Free Eye Exams • Vision USA • Through the American Optometric Association • Has its own requirements • Provides basic eye care services for those who are uninsured and do not qualify for government assistance • www.aoa.org/visionusa • (800)-766-4466

14. Common Eye Disorders • Nearsightedness (myopia) • Most common visual problem among students • A type of refractive error • Close objects are clear • Far-away objects are blurry • Students may squint to see blackboard or presentation materials • Can be corrected with corrective lenses such as glasses or contact lenses

15. Common Eye Disorders • Farsightedness (hyperopia) • Also a common visual problem among students • A type of refractive error • Close objects are blurry • Far-away objects are clear • Students may squint while reading or hold reading material farther away from face than normal • Can be corrected with corrective lenses such as glasses

16. Common Eye Disorders • Astigmatism • Often co-occurs with nearsightedness or farsightedness • A type of refractive error caused by an abnormally shaped cornea • Can be corrected with corrective lenses such as glasses or contact lenses

17. Common Eye Disorders • Strabismus • Issue with eye muscles • Student’s eyes appear to be focusing on two different points • Often co-occurs with amblyopia • Glasses or eye muscle exercises can treat strabismus. Sometimes surgery is needed.

18. Common Eye Disorders • Lazy Eye (Amblyopia) • One eye is stronger than the other • Student may show signs of strabismus, but the two do not always co-occur • Over time, the brain may begin to disregard signals from the weaker eye • If it is not detected early, amblyopia can lead to a permanent loss of sight in the weaker eye • This disorder is only detectable through an eye exam from an optometrist or ophthalmologist

19. Common Eye Disorders • Pink Eye (Conjunctivitis) • Common in schoolchildren • The conjunctiva (lining on eyelid and part of eyeball) become infected and inflamed • Highly contagious • Prescription eye drops can treat bacterial forms • Viral forms clear up on their own and cannot be treated, but sometimes eye drops are needed to relieve inflammation.

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