Why optometrists think California students need better eye exams
Assemblywoman Autumn Burke says she just wants to help children whose unidentified vision problems may be holding them back academically. But her bill encouraging more comprehensive eye exams when students enroll in school has divided eye doctors – the latest skirmish in a long political history of medical groups squaring off over their scope of practice.
The Marina Del Rey Democrat’s Assembly Bill 1110 requires parents to submit the results of an eye exam conducted by a physician, optometrist or ophthalmologist when enrolling their children in elementary school. It would allow them to opt out, however, leaving the assessment to school nurses, who already conduct vision screenings in second, fifth and eighth grades under California law.
Burke believes those screenings are insufficient, pointing to a National Institutes of Health study that found a third of eye issues are not identified through school exams. She said getting kids in front of doctors – who evaluate the pupils, check for tumors and assess how the eyes are working together, in addition to testing distance and color – particularly helps students who may be treated as having behavior problems when they simply can’t see.
“Children can’t learn when they can’t see the blackboard,” Burke said. “When a minority is labeled a ‘problem,’ that stays with them forever.”
The bill was conceived by the California Board of Optometry and is supported by the California Optometric Association. But state and national ophthalmologists groups, the school nurses organization and the California Medical Association have all come out against it, arguing that the policy is expensive and unnecessary.
The medical association declined to answer questions about its position on the record. In a statement, spokeswoman Joanne Adams said, “CMA supports all children getting regular vision screenings to catch eye disorders.”
“We’re concerned that this mandate is an inefficient use of healthcare resources that places an undue burden on families and children by requiring costly exams for children who don’t present vision problems,” she said.
Organizations representing medical professionals often face off at the Capitol over bills that expand what they are allowed to do, perhaps encroaching on a competing field. Another bill last year giving optometrists permission to perform laser procedures and administer vaccines failed amid opposition from ophthalmologists and the California Medical Association.
Burke acknowledged it may be a “David vs. Goliath situation” to pass AB 1110, which advanced out of its first committee on Wednesday. She said insurance plans are required under the Affordable Care Act to cover the eye exams for children, and any copays or other minor costs to families are worth the result: “You are honestly talking about changing a child’s life.”