INDIANA LIONS FOUNDATION | LIONS OF INDIANA STATE OFFICE HOLDING CORP.
Operation KidSight Screens
for Amblyopia in Preschoolers
Over 5,000 Indiana preschoolers have been screened for amblyopia (vision loss) since July 2003 in Operation Kidsight, a three-year, joint program of the IU Department of Ophthalmology, the IU School of Optometry, and the Indiana Lions Clubs.
For these screenings, individual Lions Clubs send volunteers throughout Indiana to "photoscreen" pre-schoolers for amblyopia. In the photoscreening process, the child's eyes are photographed using a special flash technique, basically a Polaroid picture of the "red eye" reflex with which most photographers are familiar. Depending on the nature of the light reflections obtained, the ophthalmologists determine if the child is at risk for amblyopia. Photoscreening is 85-90% effective in detecting the problems which can cause reduced vision in children.
"We've made tremendous progress in different parts of the state," notes Janice Chapman, coordinator of Operation Kidsight.
Lions View
Charles Haffner, Program Director of Operation Kidsight for the Indiana Lions Foundation, provides a Lion's perspective of the program. Mr. Haffner, a retired middle school principal, is devoted to the program. "The medical profession has known for 50 years the importance of early vision screening for children, but we've had no [comprehensive] program in Indiana to effectively reach our children," notes Mr. Haffner. Operation Kidsight helps fill this void.
The approach of Operation Kidsight is two-fold: to assist in protecting children's eyesight by offering these screenings and at the same time, educating parents as to the importance of eye examinations for children. "The average parent feels that the pediatrician checks his /her child for everything, when in reality, most pediatricians have only limited training in identifying vision problems.
Another part of the problem is that some people only rarely come into contact with the medical system. "About a third of our population is missed because they just don't have the interaction with the medical system. This is tragic especially with something (vision screenings) this easy to do," states Mr. Haffner.
“People are just not aware of the devastation that vision problems cause,” he states. “The earlier the vision problem is caught, the greater the chance that the problem is treatable and the less expensive the problem is to fix. We discovered a child that had already gone blind in one eye and his parents didn’t even know,” relates Mr. Haffner.
Medical Director's View
Daniel E. Neely, M.D., is medical director for Operation Kidsight. He writes the following: "Last year we screened 4,847 children. This surpasses our goal of 3,000 in the first year. We would like to double the size of the program every year for the next four years, and this year our goal is 6,000 children. The eventual need to cover every child at a single age level in the state of Indiana is approximately 75,000.
"Preschool vision screening does exist in Indiana; we are not the first to provide this service. Prevent Blindness Indiana , in particular, has done a nice job of screening school aged and younger children. Other organizations and individuals also perform various amounts of vision screening. The problem is that no uniform, statewide program exists to target this most vulnerable population of preschool children at risk for amblyopia. We hope to help fill the gaps and eventually would like to be able to screen every single child in Indiana before they get to school age.
"The target population of preschool children (age 1 to 5) is not only the most vulnerable to amblyopia related to refractive errors, strabismus, ptosis, and cataracts. They are also the most difficult to screen because they may be preverbal or unwilling/unable to read a standard eye chart. Therefore, we are using a photoscreening camera, the MTI photoscreener, to take Polaroid photos of the eye's 'red reflex.' The characteristics of these photographs are then interpreted by a special reading center at Vanderbilt University in Nashville, Tennessee. We eventually hope to interpret our own photographs once we have established sufficient volume to be proficient and accurate with a high degree of reliability.
"Once a child fails a screening, (s)he is referred to a local ophthalmologist or optometrist for a comprehensive eye examination (on a fee-for-service basis), and we collect a follow-up form to insure that adequate examination and follow-up have been arranged. The results are recorded in our database so that we can monitor the quality of our photoscreening interpretations. If a family needs help finding a doctor, arranging for insurance or paying for services, this is handled on a case by case basis. The program is not designed to offer free eye care.
"As of early March 2005, 5,111 children had been screened. Of these, 290 (5.6%) were referred to doctors. Of the 290 referred, follow-up forms were received for 110. Of the 110, 74% were found to have amblyogenic risk factors and required treatment. Obtaining and insuring appropriate follow-up is the most difficult task. Our program has provision to add a follow-up care coordinator, and this should help considerably."
Future
"While the program is being launched by a three-year grant from Lions Clubs International along with the Indiana Lions, at the end of three years, the program does not disappear," says Dr. Neely. "It is designed to be self-sufficient and has a mechanism in place that provides ongoing funds that will match the increasing volume of the program."
To find out about the nearest screening for your child or to arrange for a free screening for your child’s preschool or day care, contact Janice Chapman, Operation Kidsight, at (317) 578-0491, kidsight@sbcglobal.net.
Operation KidSight Links
La Forma de la investigación del Resultado del Examen
Operation Kidsight News Media Participant Release Form
PHOTOSCREENING – How to Protect Children’s Eyesight
Photoscreening Information Form
Photoscreening Information Form - Spanish
Screening Exam Result Form - Consent