To the Editor:
I noticed that the VCA (Vision Council of America) purchased advertising space in the September 2004 issue of Review of Ophthalmology promoting potential federal legislation HR2173. There is a fairly extensive campaign and political urgings found on their website. HR2173 aims to direct $70 million federal dollars outside the Medicaid/Medicare/ Tricare budget to cover comprehensive children's eye exams, dispense glasses and administer the program. Comprehensive eye exams would be directed to all children from families whose incomes do not qualify for other federal vision coverage.

The American Association for Pediatric Ophthalmology and Strabismus (AAPOS) with enthusiastic endorsement from AAO (American Academy of Ophthalmology), AAP (American Academy of Pediatrics) and AAFP (American Academy of Family Practice) does NOT support HR2173 because there is a much better bill, HR3602, instead. HR3602 would provide similar levels of funding to cover vision screening and comprehensive exams with limited administrative costs. As such, inexpensive screening would identify the high-risk children. Then the more expensive comprehensive exams and spectacles would be provided in a more cost-effective manner.1

Pediatric ophthalmologists can work together very effectively in combination with the optical industry and pediatric optometry as witnessed by the Pediatric Eye Disease Investigator Group (PEDIG) and the Amblyopia Treatment Studies (ATS-5 and ATS-7). Early detection combined with thorough, consistent treatment can eliminate most amblyopia blindness.

We urge support for HR3602—cost-effective, focused screening and treatment of amblyopia for children who economically "fall through the cracks." 

Sincerely Yours,
Robert W. Arnold, MD
AAPOS Vision Screen Chair

1. Donahue SP. How often are spectacles prescribed to "normal" preschool children? J AAPOS. 2004; 8(3):224-229.