• American Academy of Ophthalmology Offers Guidance on the New Affordable Care Act Childhood Vision Care Benefit

    WASHINGTON —  As the Affordable Care Act insurance programs start open enrollment Oct. 1, and many uninsured parents begin signing up for new health plans, the American Academy of Ophthalmology – in conjunction with other key health organizations – is reiterating its guidance on the importance of childhood vision screening and comprehensive eye exams, and encouraging parents to take advantage of a newly-acquired benefit that provides full coverage of essential eye care services for kids.  

    Beginning Jan. 1, 2014, health plans offered through state insurance exchanges will provide full coverage of childhood comprehensive eye exams and glasses or contact lenses to correct refractive errors. Initially, the Affordable Care Act only provided coverage for child and adolescent vision screenings during well-child visits, so the new benefit will make it easier for families to follow-up on any problems identified through screenings.

    As more than half of uninsured children have never had a well-child visit,[i] which typically includes a vision screening, and newly-insured parents may be unfamiliar with the process, the American Academy of Ophthalmology – along with the American Academy of Pediatrics and the American Association for Pediatric Ophthalmology and Strabismus – is reminding parents that children should receive vision screenings at the following stages: at all well-child visits from the time they are born until they are three years old, each year between the ages of three and five years, and every one to two years after age five.  

    Screening is crucial in facilitating the early detection and treatment of childhood vision impairments that may not be correctable later in life. It is a quick, efficient and cost-effective method to identify patients who have indications of a vision problem or a potential vision problem. Screening can be performed by a pediatrician, family physician or other properly trained health care provider. It is also often offered at schools, community health centers or community events. 

    While screening cannot diagnose exactly what is wrong with a child's eyes, it can indicate whether the child should have a comprehensive eye examination with an ophthalmologist – a medical doctor who specializes in the diagnosis, medical and surgical treatment of eye diseases – or an optometrist – a health care professional who provides primary vision care ranging from sight testing and correction to the diagnosis, treatment and management of vision changes.  

    In contrast to vision screening, a comprehensive eye exam can facilitate diagnosis of visual problems. It involves the use of eye drops to dilate the pupil, enabling a more thorough investigation of the overall health of the eye and the visual system. The American Academy of Ophthalmology advises parents to seek a comprehensive eye exam if: 

    • Their child fails a vision screening.
    • Vision screening is inconclusive or cannot be performed.
    • Referred by a pediatrician or school nurse.
    • Their child has a vision complaint or observed abnormal visual behavior, or is at risk for developing eye problems. Children with medical conditions e.g., Down syndrome, prematurity, juvenile idiopathic arthritis, neurofibromatosis or a family history of amblyopia, strabismus, retinoblastoma, congenital cataracts or congenital glaucoma are at higher risk for developing pediatric eye problems.
    • Their child has a learning disability, developmental delay, neuropsychological condition or behavioral issue. 

    "Parents who previously avoided getting their child's vision checked or corrected due to cost concerns now have an affordable way to access these crucial services," said Michael X. Repka, M.D., medical director for governmental affairs for the American Academy of Ophthalmology and pediatric ophthalmologist. "The new Affordable Care Act pediatric vision benefit makes it easy for parents to ensure that their children have a healthy start in life and aren't left behind due to sight problems. Good vision is key to a child's physical development, school success and well-being, so now is the time to take action."

    To learn more about state health insurance exchanges and the new vision benefits available under the Affordable Care Act, visit www.healthcare.gov. For more eye health information, visit EyeSmart. To learn about medical homes, visit http://www.medicalhomeinfo.org/for_families.  

    About the American Academy of Ophthalmology
    The American Academy of Ophthalmology, headquartered in San Francisco, is the world's largest association of eye physicians and surgeons — Eye M.D.s — with more than 32,000 members worldwide.  Eye health care is provided by the three "O's" – ophthalmologists, optometrists, and opticians. It is the ophthalmologist, or Eye M.D., who has the education and training to treat it all: eye diseases, infections and injuries, and perform eye surgery. For more information, visit www.aao.org. The Academy's EyeSmart® program educates the public about the importance of eye health and empowers them to preserve healthy vision. EyeSmart provides the most trusted and medically accurate information about eye diseases, conditions and injuries. OjosSanos™ is the Spanish-language version of the program. Visit EyeSmart or OjosSanos to learn more.

    [i]No Shelter from the Storm, Campaign for Children's Healthcare, 2006. Accessed at: http://www.childrenshealthcampaign.org/tools/reports/Uninsured-Kids-report.PDF