THE IMPORTANCE OF VISION TO A PART III: Optometry's Specialized Role in Service to Children and Youth Vision is a child's most precious sense. A child with good vision performance at near and far is usually a good student for he can spend his efforts and energy in mastering written concepts, rather than mastering the problem of seeing words. Optometry is dedicated to enhancing the child's operational vision. As early as 1910, shortly after the first White House Conference on Children and Youth, it was recognized that vision care required a type of education which could not be assimilated in, or made adjunct to, any existing professional curriculum. It was obviously necessary to combine knowledge from many diverse sciences if the science of vision care was to emerge as a practical discipline. Consequently, leading universities began setting up specialized optometric courses for professional education in vision care, combining physics, optics and mathematics with psychology and such health subjects as anatomy, physiology and pathology. Today accredited courses require a minimum of 5 years (some require 6 years) of study at the college level. Today, moreover, about 35 percent of all students entering optometry colleges have already completed four-year undergraduate courses of study with bachelor's degrees. If they have concentrated on science subjects in college, they can thereupon finish optometry requirements in three or four additional years, receiving customarily the degree of O.D. (doctor of optometry). Some schools grant degrees of bachelor of science in optometry and master of science in optometry, doctor of optometry and doctor of philosophy degrees in physiological optics. The accredited colleges and universities offering optometric courses include: Illinois College of Optometry; Indiana University; Los Angeles College of Optometry; The Massachusetts College of Optometry: The Ohio State University; Pacific University; The Pennsylvania State College of Optometry; Southern College of Optometry; University of California and the University of Houston. The optometric curriculum, in addition to concentrating on subjects directly related to vision care, also devotes about one-fourth of the student's work to a broad study of the human body, with particular emphasis on eye diseases and symptoms of other diseases which can be detected in the eyes. Optometrists, of course, do not treat patients medically; however, the long study devoted to eye and other diseases enables the optometrist to refer for appropriate professional care patients whose eyes reveal evidences of possible disease. Availibility of Vision Care Every year more than 30,000,000 Americans obtain vision care. Millions more who need such care neglect to seek it. If all who needed vision care were to seek to make appointments with qualified practitioners, they could not all be served. At present, there are about 21,000 optometrists or one to every 8,000 persons, (the ratio of certified ophthalmologists to population is 1 to every 45,000 persons). To serve 10 years from now merely the same percentage of the population now receiving vision care, we would have to double the present number of optometrists. The greater need for more professional optometrists is in the Southern States, where the existing ratio is as low as 1 to 15,000. (See Appendix Exhibit C for numbers and ratios of licensed optometrists and certified ophthalmologists by states.) Nevertheless, there are today members of the optometric profession located in almost every rural community, and town, and in every city in the United States, and in nearly all instances these professional men and women devote a major share of their practices to the special vision problems of children and youth with particular emphasis on preventive care. Just as a conscientious dentist strives to save a child's permanent teeth and keep them strong for a lifetime, rather than later try to remedy the ravages of dental neglect, so the optometrist strives to prevent damage to the child's vision in preference to correcting it later in the child's life. Functional Vision Care In this connection, optometry has pioneered in functional vision and developmental vision, with emphasis on effective near point performance, and has developed such innovations as con tact lenses, visual training, and the use of bifocal lenses for children in improving classroom visual performance. Often bifocal lenses contain a prescription lens only in the lower segment and merely plain glass in the upper segment, for children needing no assistance in distance sight, but requiring appropriate lens prescription for nearpoint tasks. The bifocal technique has replaced the older practice of prescribing a single lens where the child needs help only in nearpoint sight but not at distance or greater help at near than at distance. This is but one illustration of optometry's development of the functional vision concept, to help the child perform better in all of his vision tasks. The American Optometric Association, and the state associations affiliated with it, are constantly seeking new insight on means of strengthening the profession's services to the public and particularly to children and youth by disseminating new knowledge in this field. In addition, numerous post-graduate courses to keep practitioners up to date on new developments are being offered to the members of the profession through the Schools and Colleges of Optometry, through state and national associations, and by two ancilliary organizations, the American Academy of Optometry, and the Optometric Extension Program Foundation, both of which devote full time efforts to continuous research and to the further education of the practicing, licensed optometrist. OPTOMETRY'S ORGANIZED SERVICES IN BEHALF OF THE CHILD The continuing work of the American Optometric Association in relation to the welfare of children from birth through college is centered in the activities of the Committee on Visual Problems of Children and Youth, which is also charged with responsibility for organizing the American Optometric Association's participation each decade in the White House Conference on Children and Youth. In the 10 years since the last White House Conference, the Committee on Visual Problems of Children and Youth has sponsored an annual multiprofessional forum on vision problems of children and youth in Cleveland. Each year since 1950 the attendance at these conferences has grown as educators, psychologists, optometrists and others have recognized in the annual forum an excellent opportunity for the exchange of information, techniques and methods for aiding and enhancing the developmental vision of children. As the annual Cleveland conference of the American Optometric Association's Committee on Visual Problems of Children and Youth has become more and more successful, regional groups have found it worthwhile to establish similar meetings. Thus, in three successive years, such forums have been held for the Middle West in Chicago; two such annual events have occurred for the West Coast in Los Angeles, and this year the first Southern Forum is being sponsored by the Florida Optometric Association. On the state level, most of the state optometric associations affiliated with the American Optometric Association have conducted similar forums, with subsequent report sessions at the local society level to disseminate broadly the new knowledge developed at national, regional and state meetings. Active Sponsorship of Multi-Professional Approach In every possible way, organized optometry has sought to sponsor or encourage a multiprofessional approach to the vision and related problems of children and youth. As a profession, and through the dedicated work of many individual vision care specialists, optometry has participated in a variety of programs set up to aid various types of exceptional children, with particular emphasis on the partially-seeing, the retarded, and the brain-injured, but covering also all other categories of exceptional children for whom special programs are being undertaken on the local, regional, state or national level. In the field of vision screening in the schools, optometry has found that the multiprofessional approach, in which optometrists, ophthalmologists, school administrators, public health officials, teachers and parents cooperate in the development of a program, provides the best hope of achieving a successful and effective and practical result. [9] In practical operation, such an approach is being used with encouraging success in Euclid, Ohio schools, where children are tested not only by Snellen chart for visual acuity at 20 feet but by additional tests which reveal difficulties in using the eyes together with ease and efficiency for boardwork, deskwork and reading. In furtherance of their objective of integrating vision care programs into school health services, State Committees on Visual Problems of Children and Youth are cooperating not only with the public agencies concerned but with civic and fraternal groups such as Lions, Kiwanis, Rotary and others to establish voluntary vision testing programs where the states are unable to provide official programs. AOA Publications To Help Parents, Teachers A variety of publications and an authoritative new book have been published by, or underwritten by, the optometric profession, to help parents, teachers and all groups working with, and interested in, the visual welfare of children to understand the processes by which children learn to see more efficiently. These materials may be obtained from the American Optometric Association, 4030 Chouteau Avenue, St. Louis 10, Missouri. The book referred to, PRE-SCHOOL VISION, by R. J. Apell and R. W. Lowry, Jr., published in 1959, was prepared under a research grant from the American Optometric Foundation to the Gesell Institute of Child Development at the request of the American Optometric Association's Committee on Visual Problems of Children and Youth. [1] It describes a battery of visual tests developed for pre-school children not only to detect errors of refraction but also to appraise the child's visual performance in relation to others of his own age, thus indicating, from the child's visual behavior, whether he may need special vision help to become an achiever in the school environment. A leaflet published by the American Optometric Association, YOUR BABY'S EYES, is intended to help parents to encourage the child's visual development in the right direction from the earliest days of infancy. Another pamphlet, MOMMY AND DADDY, YOU CAN HELP ME LEARN TO SEE, (referred to earlier in this report) has been published by the Association under the sponsorship of the Woman's Auxiliary of the AOA, as a guide for parents on observation and application of developmental principles in vision guidance of infants. And to guide parents further in observing the child's visual performance, the Association has also published a folder CHECK YOUR CHILD'S VISION. Other useful publications issued by the American Optometric Association in a continuing and determined effort to increase public understanding of vision problems and of the need for preventive vision care include: MANUAL ON VISION CARE OF THE NON-ACHIEVING CHILD, which, besides providing the optometrist with background technical information, has been found to be particularly useful to educators, especially those connected with reading clinics. [18] TEACHER'S GUIDE TO VISION PROBLEMS WITH CHECKLIST, which discusses symptoms of a child's visual difficulty while using his eyes "on the job" of learning in the classroom. [53] STUDENT VISION REPORT FORMS, which enable the optometrist to provide parents and teachers with a readily understandable outline of the elementary or secondary school student's visual abilities. CLINICAL GUIDE TO AMBLYOPIA THERAPY, to assist in the early detection and subsequent care of children with strabismus or amblyopia (a dimness of vision not fully corrected with lenses). [37] MANUAL ON THE PARTIALLY SEEING, to be released during 1960. In addition reprints are available of numerous articles on the vision problems of children and youth written by members of the optometric profession for various publications. These, and other materials- including monographs, posters, and a filmstrip ADVENTURES IN SEEING (of which more than 15,000 prints have been distributed on request to elementary schools within the past two years)- are available to groups or individuals interested in more information on the importance of vision to a creative life in freedom and dignity for America's millions of children and youth. OPTOMETRY LOOKS AHEAD CONFIDENTLY TO 1970 Each White House Conference on Children and Youth since the first one a half-century ago has served humanity in two important ways: 1) as a device for assembling together in understandable terms and workable dimensions the sum total of all new knowledge of the preceding decade in matters involving the welfare of children; and, 2) in inspiring all of the professions, disciplines and lay groups participating to exert renewed efforts to solve in the succeeding decade the unanswered questions, the riddles and dilemmas inherent for children in the dynamics of community and national life in a constantly changing American society and economy. The 1950 White House Conference was an outstanding success from the standpoint of both criteria, and the 1960 White House Conference promises to match and exceed the contributions of its predecessor. In the field of vision care, the 1950 Conference set off an explosive charge of scientific curiosity leading into new paths of research, with often remarkable results. In fact, so much has been accomplished in the field since the 1950 Conference that the optometric profession is encouraged to believe the next 10 years will bring even greater progress in conserving and improving the visual abilities of America's youth, thus making possible a tremendous upsurge in educational achievement and assuring a better life for millions of Americans, and a sounder, firmer basis for our freedom. In the concluding section of Part 1 of this report, the American Optometric Association's Committee on Visual Problems of Children and Youth outlined in detail the many existing gaps in our knowledge about vision care and vision problems and the research goals which we must pursue diligently in the coming decade. There is, therefore, no necessity for repeating that material here. These are goals not only of optometry but of all groups which recognize the 80118 O-62-35 close and direct relationship between a child's visual capabilities and his opportunities for achievement in school and in later life. Optometry as a profession takes great pride that its efforts and its cooperation have played a key role in the research in vision care undertaken so successfully in the past 10 years. This research has created a broad new pattern of knowledge in vision care which now constitutes the foundation on which future research efforts can optimistically be erected. Challenge of Future CAN and WILL be Met As a comparatively new discipline itself, optometry has had the necessary flexibility in outlook to enable it to strike out inquiringly into new and uncharted fields of research without fear of disturbing encrusted doctrines and grimly held dogmas inherited from another era. In concluding this report, the Committee on Visual Problems of Children and Youth, of the American Optometric Association, on behalf of the 21,000 licensed optometrists now practicing in every State of the Union, wishes to assure the delegates to the 1960 White House Conference on Children and Youth of optometry's determination as a profession to continue to search, probe, inquire, challenge old theories and test new ones. To this great goal; we pledge: That every means will be sought by optometry, working in our own practices and in sincere cooperation with other disciplines, to solve more of the vision problems of America's youngsters. This will assure better vision for children and youth and thus a more creative life in freedom and dignity for the boys and girls who, more than missiles or armadas of ships or stone and mortar and steel, represent our nation's greatest "weapon" in defense of our way of life. This is our best hope for achievement of a decent world in which freedom and the concept of the dignity of the individual can survive and flourish. The challenge of the coming decade to the children and youth of America in the field of vision care, as in all other vital areas of child welfare, CAN and WILL be met if, as a nation, we have the vision to work together and utilize our resources and skills with determination and intelligence. |