Sarah Brodsky

The state of Missouri may soon require comprehensive eye exams for all students entering kindergarten or first grade:

Parents without insurance will be responsible for the $100 to $165 vision exam.

Children on Medicaid will be covered by the state, and families that can't afford it can apply for help from civic groups like the Lion's Club or tap into $99,000 that will be available annually from the Blindness Education, Screening and Treatment Program Fund, Sen. Delbert Scott said.

But school nurses estimate one year's worth of exams for the 70,000 Missouri children entering kindergarten in the fall will cost the state and private donors $2.4 million to $7 million. (Medicaid reimburses doctors about $43 for a comprehensive eye exam.)

The article includes some horror stories of children who were diagnosed as learning disabled because of vision problems that school nurses couldn't detect during standard in-school exams.

Overidentification of learning disabilities is a problem. However, as the school nurses quoted in the article point out, requiring full eye exams for everyone is a costly solution. It would be much cheaper to require full eye exams only for students who are suspected to have learning disabilities. An even better idea would be to publicize the information about private donors who help parents pay for exams, without mandating these comprehensive exams for anyone. Parents can decide which level of exam their kids need.

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Sarah Brodsky

Sarah Brodsky