Education Week - May 30, 2018 - 8

A Growing Vision Problem Is Hidden in Plain Sight
A third of children
need eye exams

Student Brooklyn Richotte
sits for a vision screening
at Liberty Elementary
School in Omaha, Neb.,
last year. The Child Vision
Collaborative examined
students' eyes for free,
providing glasses as
needed.

Despite the spread of nearsightedness among U.S. schoolchildren,
nearly 1 in 3 has not had a vision
screening in at least two years,
according to a new Education
Week Research Center analysis
of federal data, and research suggests several ways schools may
help reduce children's risk of bad
eyesight.
Myopia, or nearsightedness,
means that a person has good vision for close objects but difficulty
seeing things farther away. The
problem, caused when the eyeball
grows too long from back to front,
can in more severe cases mean that
a student cannot see clearly even a
foot in front of her face.
In 2017, the National Eye Institute, part of the National Institutes
of Health, reported that nearly 42
percent of Americans are nearsighted, compared with only 25
percent in the 1970s. About 4 percent have severe, or "high" myopia,
which can lead to blindness.
The problem is just as bad or
worse in some other industrialized
countries. Australia and Great
Britain have seen similar increases
in myopia. In China, India, and
throughout industrialized Asia, the
National Eye Institute reported
that 80 percent to 90 percent of
all high school graduates are nearsighted, and 20 percent have high
myopia.
"The rate of children needing
glasses is so much greater than I
ever imagined," said Carolyn Amberry, who is in her 17th year as
a school nurse at Long Beach Unified schools in California. At Lincoln Elementary, one high-poverty
school where Amberry worked, "I
couldn't believe at a school of 1,200
kids, I had more than 300 needing
glasses."

Megan Farmer/Omaha World-Herald via AP

By Sarah D. Sparks
& Alex Harwin

NOT EVERY CHILD GETS VISION TESTING
States vary widely in the percentage of children who have not had an eye exam in at least two years,
based on 2016 federal health data. Wyoming tested nearly twice as many children as neighboring Idaho.

WA 30
MT 32

VT 28

ND 32

OR 30

MN 27
ID 40
WY 24

WI 30

SD 36

MI 28

UT 34
CA 31

AZ 33

PA 28

IA 29

NE 33

NV 42

NY 29

IN 34

IL 32
CO 29

KS 27

OK 34

NM 33

MO 30

OH 31
WV 30 VA 32

KY 32

NH 28
MA 27
RI 26
CT 23
NJ 24
DE 26
MD 28
DC 35

NC 26

TN 28
AR 35

SC 33
MS 34

LA 30

TX 31

ME 32

AL 30

GA 28

FL 36
AK 29

Natural Light Helps
Nearsightedness does run in
families, but the spread of the vision problems has raised concerns
among educators and researchers. Studies have pointed to both
the rise of computer and mobile
use and the reduction of recess in
schools as potentially contributing
to the problem.
"With technology nowadays,
[students'] faces are always in a
screen," said Leila Bajarin, who
coordinates vision screenings for
students at Kalihi Waena Elementary in Hawaii. "I think that makes
[eyesight] deteriorate a lot quicker
at a young age."
She's not wrong, research says,
but longitudinal studies suggest
that reading and studying either
on computers or in print-so-called
"near work"-do not fully explain
the rapidly rising rates of nearsightedness.
"There's no question that the

HI 32

23%

Percentage of students who have not had an eye
exam in two or more years

LOOKING NATIONWIDE
Nearly 1 in 3 children hasn't had vision
tested in the past two years-if at all.
Of those that have received a recent eye
exam, 16 percent did so through school.

Percentages may not add up to 100 due to rounding.

SOURCE: Education Week Research Center analysis of the National
Survey of Children's Health Data, 2018.

8 | EDUCATION WEEK | May 30, 2018 | www.edweek.org

30%
69

[electronic] devices and students
starting to use them so early contributes to the earlier onset of myopia we're seeing," said optometrist
Amanda Hikin, "but a lot of the
kids we are seeing are [in poverty]
and may not have as much access
to some of those things. But still
we see quite a lot of myopia and
astigmatism."
Instead, researchers including
Donald Mutti, an optometry professor at Ohio State University in
Columbus, have found what children do inside is less important a
predictor of myopia than the time
children spend outside. Young
children's eyes grow quickly in
infancy and toddlerhood, but that
growth slows during the school
years. If instead, the eye continues to lengthen at its early pace,
light coming through the lens will
not focus correctly, creating myopia. Mutti and other researchers
have suggested exposure to natural light in the elementary years
helps to trigger the slower pace of
growth-so being outside less during and after school also may boost
the risk of nearsightedness.

Spotting Vision Problems
The American Association for
Pediatric Ophthalmology and Strabismus recommends children have
their vision checked at least every
other year after age 5, but states
differ widely in whether and how
often students are screened. In
Connecticut and New Jersey, for
example, just over 23 percent of
children younger than 18 have not
had a vision check in the past two
years; in Idaho and Nevada, that
share is more than 40 percent,
according to the research center
analysis of data from the National
Survey of Children's Health, an
ongoing federal study of children
in more than 364,000 households
across the country. Children in
poverty also were more likely than
their wealthier peers to go two
years or more without screening,
the analysis showed.
At Kalihi Waena Elementary,
Bajarin recalled one child, who
was among the more than 32 percent of schoolchildren in Hawaii
who hadn't had their eyes tested
in two years. The 5th grader's
teachers noticed she had trouble
seeing two years ago-"She was
moved up [in the classroom], but
even at the front of the class, there
is information up on all walls"
that she couldn't see, Bajarin
said-but for two years, her father argued he didn't have time to
take his daughter for an eye exam.
"Thankfully, we convinced him be-

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Education Week - May 30, 2018

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