As the Affordable Care Act insurance programs began open enrollment Oct. 1, and many uninsured parents begin signing up for new health plans, the Florida Society of Ophthalmology (FSO) and the American Academy of Ophthalmology (AAO) – in conjunction with other key health organizations – are reiterating their guidance on the importance of childhood vision screening and comprehensive eye exams, and encouraging parents to take advantage of a newly acquired benefit that provides full coverage of essential eye care services for kids.

Beginning Jan. 1, 2014, health plans offered through state insurance exchanges will provide full coverage of childhood comprehensive eye exams and glasses or contact lenses to correct refractive errors. Initially, the Affordable Care Act only provided coverage for child and adolescent vision screenings during well-child visits, so the new benefit will make it easier for families to follow up on any problems identified through screenings.

As more than half of uninsured children have never had a well-child visit,^[i] which typically includes a vision screening, and newly insured parents may be unfamiliar with the process, the FSO – along with the American Academy of Ophthalmology, the American Academy of Pediatrics and the American Association for Pediatric Ophthalmology and Strabismus – is reminding parents that children should receive vision screenings at the following stages: at all well-child visits from the time they are born until they are three years old, each year between the ages of three and five years, and every one-to-two years after age five.

Screening is crucial to facilitating the early detection and treatment of childhood vision impairments that may not be correctable later in life. It is a quick, efficient and cost-effective method to identify patients who have indications of a vision problem or a potential vision problem. Screening can be performed by a pediatrician, family physician or other properly trained health care provider. It is also offered at schools, community health centers or community events.

While screening cannot diagnose exactly what is wrong with a child’s eyes, it can indicate whether the child should have a comprehensive eye examination with an ophthalmologist – a medical doctor who specializes in the diagnosis, medical and surgical treatment of eye diseases – or an optometrist – a health care professional who provides primary vision care ranging from sight testing and correction to the diagnosis, treatment and management of vision changes.

In contrast to vision screening, a comprehensive eye exam can facilitate diagnosis of visual problems. It uses eye drops to dilate the pupil, enabling a more thorough investigation of the overall health of the eye and the visual system. The FSO and the AAO advise parents to seek a comprehensive eye exam if:

• Their child fails a vision screening.
• Vision screening is inconclusive or cannot be performed.
• Referred by a pediatrician or school nurse.
• Their child has a vision complaint or observed abnormal visual behavior, or is at risk for developing eye problems. Children with medical conditions (e.g., Down syndrome, prematurity, juvenile idiopathic arthritis, neurofibromatosis) or a family history of amblyopia, strabismus, retinoblastoma congenital cataracts or congenital glaucoma are at higher risk for developing eye problems.
• Their child has a learning disability, developmental delay, neuropsychological condition or behavioral issue.

"The new Affordable Care Act pediatric vision benefit makes it easy for parents to ensure that their children have a healthy start in life and aren’t left behind due to sight problems, said Stacey Kruger, MD, a pediatric ophthalmologist and FSO board member from Miami. "Good vision is key to a child's physical development, school success and well-being, so now is the time to take action."

To learn more about state health insurance exchanges and the new vision benefits available under the Affordable Care Act, visit www.healthcare.gov. For more eye health information, visit the American Academy of Ophthalmology's public education website at www.geteyesmart.org.

[i]No Shelter from the Storm, Campaign for Children’s Healthcare, 2006. Accessed at: http://www.childrenshealthcampaign.org/tools/reports/Uninsured-Kids-report.PDF