When Affordable Care Act insurance programs start open enrollment Oct. 1, parents of uninsured children will be able to sign up for new health plans through state insurance exchanges which, beginning Jan. 1, 2014, 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. The American Academy of Ophthalmology – along with the American Academy of Pediatrics and the American Association for Pediatric Ophthalmology and Strabismus – recommends that children receive vision screenings at regular intervals.

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 or an optometrist.

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.

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

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