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Kristan Gross

Imagine trying to learn with blurry vision. Would you know the difference between a circle and a square if you could not see a square’s sharp corners? What about the difference between the letters ‘e’ and ‘o’ if you couldn’t make out that small line and space in the ‘e’?

Unfortunately, these scenarios are all too common for many American children. Approximately 24 percent — one in four — of adolescents in the U.S. with correctable refractive error do not have adequate access to vision correction services, according to the non-profit advocacy organization Prevent Blindness.

According to experts, 80 percent of all learning occurs visually, meaning children with poor vision are at a major disadvantage. This is not a short-term problem — kids who suffer from vision problems are less likely to do well in school, which can subsequently affect their success later in life. Along with this cost to quality of life for children, the economic costs of children’s vision disorders are also significant, amounting to $10 billion annually in the U.S.

Unfortunately, this issue is only expected to get worse. In 2010, approximately 30 million Americans suffered from myopia. By 2030, that number is expected to reach almost 40 million — spanning races and cultures. For children, trends such as increased screen time and minimal outdoor time, including less time for school recess, are resulting in more children with myopia (shortsightedness) and at a much younger age than in the past.

Access to vision care can reverse these trends and remove a critical barrier to helping children learn. A University of California Los Angeles study demonstrates that something as simple as a pair of eyeglasses could make a difference for these children. UCLA researchers evaluated Vision to Learn, a program that provides students with glasses, specifically those in low-income areas, and concluded that with a pair of eyeglasses, students’ attention, academic success and participation increased.

Early detection and correction of poor vision is key to giving all children an equal opportunity to learn and succeed socially and many experts agree that comprehensive eye exams are necessary for children by the age of three. Additionally, a National Commission on Vision & Health study found that eye exams are highly effective in identifying early vision conditions and addressing these vision issues has resulted in improved test scores.

Yet, in most states, comprehensive eye exams are not currently required alongside immunizations for students entering school, which means some children could have vision problems — and subsequently visual processing difficulties — that remain undetected by their parents and teachers for years to come.

Kentucky and Illinois are two states that require comprehensive eye exams for children before they start kindergarten and other states are also considering this requirement. In 2017, California introduced Assembly Bill 1110 to encourage a comprehensive eye exam by an optometrist or ophthalmologist upon starting school to better detect vision disorders. Although the bill was not passed before the legislative session deadline, there was valuable discussion about the costs to parents and concerns about whether the mandate placed undue burden on families.

While it’s important to acknowledge the burden of cost, it is also critical that parents understand the multiple payment options that exist for them. For example, as part of the Affordable Care Act, coverage for a child’s annual eye exam is included in all health insurance plans sold in health insurance marketplaces, as well as most new plans sold outside of the marketplace. A 2014 American Optometric Association survey indicated that two-thirds of adults did not know the Affordable Care Act mandated pediatric vision coverage.

As of January 2014, under the Affordable Care Act, millions of children 18 years of age and younger became eligible under their parents’ health insurance plans for coverage of an annual eye exam and a vision device subsidy. Those parents who are uninsured also have opportunities through Medicaid, Children’s Health Insurance Program (CHIP) and other social programs to receive eye exams for their children, and philanthropic programs exist across school districts throughout the country for those who still find themselves in need.

Unlike many other childhood conditions, poor vision can be corrected. In many cases, more serious vision conditions detected through an eye exam can be corrected early to avoid permanent loss of vision.

Children must be given comprehensive eye exams early on, preferably before they start kindergarten, and be prescribed the proper correction as necessary. It will take collaboration with academic leaders, parents and eye and healthcare professionals to identify ways to implement these solutions on a national scale. After all, when children with poor vision are too young to speak for themselves, isn’t it our job to be their voice?

By advocating for vision care, we can ensure our children will have the opportunity to see clearly — from the classroom to the playground to wherever their future takes them. This is a priceless return on a high impact investment.


Kristan Gross is global executive director of the Vision Impact Institute, a nonprofit organization seeking to raise awareness about the importance of vision correction and protection to make good vision a global priority.

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  1. LA 5 years ago5 years ago

    Great article! As a school counselor I often have had kindergarteners referred to me for behavior issues. One of the first things I do is ask to see the child’s drawings and work. If there is a noticeable difference in the quality of their work compared to other kids, I ask for a vision screening. This practice has led to 2 kinders failing vision screenings and needing corrective lenses!