[Congressional Record Volume 150, Number 103 (Thursday, July 22, 2004)]
[Senate]
[Page S8735]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. SARBANES:
  S. 2749. A bill to establish a grant program to provide comprehensive 
eye examinations to children, and for other purposes; to the Committee 
on Health, Education, Labor, and Pensions.
  Mr. SARBANES. Mr. President, today I am introducing legislation to 
provide financial support to ensure that uninsured children who have 
failed vision screenings are able to obtain the glasses or eye 
treatments they need.
  Almost every State in the Union has a system in place to detect 
vision problems at an early age. Indeed, 30 states and the District of 
Columbia require vision screening for children beginning with their 
entry into the school system and eleven additional states recommend 
such screenings for preschool children. But this system is incomplete. 
When children fail the screen, there is no requirement that they 
receive treatment of any kind. And if they are uninsured, their 
families often cannot afford a visit to the ophthalmologist and obtain 
the treatment they need to address the problem identified by the 
screening.
  Mr. President, taking steps to identify a problem, but to then fail 
to address it doesn't make sense; in particular when delay in treatment 
can have lifelong consequences. For example, one of the most common eye 
diseases of early childhood, amblyopia or ``lazy eye,'' responds to 
treatment 95 percent of the time when it is addressed by the age of 
three. If treatment is delayed until the age of five, however, the 
likelihood that the problem can be corrected is reduced to 10 percent. 
Children who cannot correct these refractive vision problems start 
school at an enormous disadvantage in terms of their ability to learn.
  The legislation I am introducing today would help to obviate this 
deficit. Simply put, it would authorize the Secretary of Health and 
Human Services, acting through the Center for Disease Control Director, 
to provide $75 million worth of grants to states for exams and 
necessary treatment for uninsured children who have failed a vision 
screening and cannot afford follow-on treatment.
  Ample evidence underscores the need for this type of legislation. A 
study conducted by Dr. Mark Preslan and Audrey Novak of the Maryland 
Center for Sight, entitled The Baltimore Vision Screening Project found 
that strabismus--also known as cross-eyes--amblyopia and refractive 
errors, occurred in higher frequencies and remained untreated for a 
population sample of youth in schools in lower income areas. The 
study's main conclusion stated, ``Children with limited access to 
specialized eye care must be provided with a mechanism for obtaining 
these services.''
  This disparity exists at the national level as well, and our minority 
populations are especially underserved. A team of researchers from the 
University of Michigan documented a national example of differential 
access to vision treatment. Their research showed that minority 
children and uninsured children are far less likely to get complete eye 
exams or glasses. A study in January's Optometry and Vision Sciences 
demonstrated that uninsured African American and Hispanic children were 
far less likely to receive vision correction, and that this disparity 
results from lack of services as opposed to less frequent occurrences 
of eye problems in these populations.
  A study by the Kaiser Commission on the Uninsured reveals that 
uninsured children are over five times more likely to have an unmet 
need for medical care. According to a report by the Caring Foundation 
for Children, 20 percent of uninsured children have untreated vision 
problems. According to Prevent Blindness America data, 12.1 million 
school-aged children have vision impairment. Among preschool-aged 
children, more than 5 percent have a problem that can cause permanent 
sight loss if left untreated, and almost 80 percent of that 5 percent 
never get an exam. Another study by the Vision Council of America 
reported that 40 percent of children who fail a vision screen do not 
receive the recommended follow-up care. The same study found the 
average delay between a failed screening and follow-up evaluation by an 
eye-care professional was 4.1 years.
  Most of our States are taking the important first step of identifying 
young children with vision problems through mandatory vision screening. 
This legislation simply takes the next step to help provide a remedy 
for those children who cannot afford treatment.
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