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Vision for Baltimore

Why can't little Johnny read? Maybe he needs glasses.

Why can't little Johnny read? When children seem distracted or bored in the classroom teachers often chalk it up to a lack of interest in schoolwork, problems at home or even an attention deficit disorder. But the same symptoms could just as easily indicate a far more common reason children have difficulty with reading and math: an undiagnosed vision problem that could easily be cured by a pair of eyeglasses. That's why we applaud a new initiative by Baltimore City Health Commissioner Dr. Leana Wen to provide free eyeglasses to every student in the city schools who needs them.

Every year, thousands of Baltimore children in grades K-8 need glasses to do their best at school. But thousands of them never get to see an ophthalmologist or optometrist — a failure for which the city pays a heavy price. Children with uncorrected vision conditions or eye health problems face serious barriers in life, academically, socially and athletically. Making high-quality eye care available can help break down those barriers and allow them to realize their full potential. It's a relatively small, cost-effective public health measure the city can take that holds out the promise of making a big difference in a child's future.

Dr. Wen estimates that only about 20 percent of students whose vision problems are detected by the limited screenings the city has done to date are able to have their condition corrected. The reasons for the breakdown are many: A parent has to find an eye care professional, schedule a visit, make sure they have the right insurance, take time off work, arrange for transportation to and from the visit and then buy the glasses after the prescription is filled. Much of that may seem routine to families that are comfortable financially, but for parents struggling to make ends meet — who may not have access to a car or paid time off from work, for example — it can be overwhelming.

The Baltimore health department is partnering with the Johns Hopkins University, the nonprofit group Vision to Learn and Warby Parker, the eyewear retailer, to set up a school-based program called Vision for Baltimore that will screen every K-8 student in the system for eye problems every year. That's an advance over the current practice, which screens students for vision problems only in pre-Kindergarten, first grade and eighth grade. Vision can change frequently during those years, which is why regular eye and vision care is so important. Most vision problems are diagnosed between Kindergarten and eight grade.

The goal is provide quality eye care and services to every child who needs them over the next three years. The screening component will assess which kids actually need glasses or other eye care services. Those who do will get free eye exams and, when necessary, two pairs of glasses from a mobile vision lab at their schools. Health department officials will help their parents navigate the paperwork of insurance reimbursements and related matters. In most cases Medicaid will pay for the exam and the glasses but not for the screening; the health department and its partners have raised about $2.1 million in private funding to cover those expenses and get the project started.

How big a difference will giving needy students eyeglasses make in terms of their school careers and future prospects? Hopkins researchers plan to thoroughly evaluate the effect of the initiative on reading scores and other academic indicators, as well as whether the results can be scaled up and replicated elsewhere. But we already know that children face increasing demands on their visual abilities as they progress in school. As they get older and the print in textbooks becomes smaller and the subject matter more complex, those who experience discomfort, fatigue and short attention spans because of vision problems are likely to fall behind. That's a huge waste of human potential that can be saved with the relatively modest cost of a pair of spectacles.

We'll await the final judgment of the Hopkins study, but the potential benefits are obvious. Children in Baltimore can face a multitude of obstacles to their learning. When one is as easy to fix as this is, there's no reason not to do it.

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