There are only two reasons NOT to continue vision screening of pre-school children. Either there is not enough data to support whether it is even needed or, based on the reality of reduced government spending, there is not enough money to continue the programs.

Working with The Oxford County Board of Health (which also serves rural Ontario), William Bobier, Network researcher and Director of the School of Optometry at the University of Waterloo, believes it is critical that choices about the necessity for screening be based on research as opposed to economics.

"We want to move from subjective to objective testing and prove conclusively the return on our investment," says Bobier. "Providers of vision screening to preschool children are not only interested in vision problems per se ­ they also wish to ensure that a child’s performance in school will not be limited by vision problems. Within this Network, we now have the opportunity to look at vision screening in a broader context."

The story about the four-year child who believed tree leaves were fuzzy round circles paints a clear picture. Children in the early stages of development don’t know they have a vision problem because it seems normal, and therefore their parents don’t know they have a problem. The children are able to adjust to farsightedness intermittently through focusing.

"This was born out in our analysis of an existing vision screening program of pre-school children which showed that over 80% of children who had a vision problem were so detected for the first time," says Bobier.

"For example, it is well established that if children sustain inequality in their eyes as they develop and this goes undetected or untreated, it leads to lazy eye. Early detection can impact this evolution and corrective steps can be taken."

In essence, this research impacts two issues. It will prove the effectiveness of vision screening ­ at the same time, it will afford the opportunity to determine the impact of the developing visual system on emerging language and literacy skills.

"We can optimize vision screening methodology for pre-school children. We can add substance to health care policy in the same context. And we can help four year old kids see the letters of the alphabet on a blackboard as clearly as they see the pointy leaves on trees."