Back to School Eye Exams are a Must

By Dr. Ann Morrison,  Binocular Vision and Pediatrics Advanced Practice Fellow at Ohio State College of Optometry.

As school starts back up in the next couple of weeks, you should be advocating the importance of regular back to school eye examinations to your patients. It has been estimated that up to 80% of learning is visual. This should be a statistic that you promote to your patients, as it is a true testament to the importance of having good vision in the classroom.

As we all know, having good vision is more than reading 20/20 on an acuity chart. According to the Center for Disease Control, vision disabilities are one of the most prevalent disabling conditions among children. Many studies have linked poor academic performance with ocular problems [1-3].

Parents are always amazed at the responses their children will give me when I ask them questions about their eyes during an examination. Some of the questions I might ask a child are: “Do you ever see the words on the page split in to two? Do they get fuzzy sometimes? Do they ever look like they are swimming?”. When a child responds “yes” to any of these types of questions, the parents quickly justify that their child never complained of those things to them. I reassure them that they are not bad parents and that children often assume that everyone else sees the way they do. I explain that unless someone explicitly tells them that these types of symptoms are not normal, a child typically will not complain.

When I have a discussion with my patients about the importance of comprehensive eye exams, I cannot begin to count how many of them think that the vision screening administered at their child’s school or at their pediatrician well-visit is counted as a comprehensive eye examination. While screenings are a great public health implementation, it is important to spend the time educating your patients on the value of a comprehensive dilated eye examination and explain that many disorders including far-sightedness, eye teaming and focusing problems are often missed in screenings that take place in the school or at their pediatrician’s office. These types of disorders can impede a child’s ability to focus and keep up with the rest of their peers.

These conversations are a great segue into discussing the Infant-See program, explaining that comprehensive eye care should start by the time a baby is one year old. This topic also sheds light on the importance of the Realeyes program, as it educates children about their eyes and the importance of visiting an eye doctor. Make sure you are making your patients aware of these programs!

I’ll leave you with a link to fantastic video put together by the One Sight program who has set up a full service optical center and exam lane inside the Oyler School in Cincinnati. What they are doing in this school is a testament to how powerful a single pair of glasses can be for a child in need.


  1. Narayanasamy, S., et al., Impact of Simulated Hyperopia on Academic-Related Performance in Children. Optom Vis Sci, 2014.
  2. Quaid, P. and T. Simpson, Association between reading speed, cycloplegic refractive error, and oculomotor function in reading disabled children versus controls. Graefes Arch Clin Exp Ophthalmol, 2013. 251(1): p. 169-87.
  3. Rosner, J. and J. Rosner, The relationship between moderate hyperopia and academic achievement: how much plus is enough? J Am Optom Assoc, 1997. 68(10): p. 648-50.

Steps You Can Do to Prepare for ICD-10

OOA Incoming President Dr. Jason Miller will provide one-hour of practice management CE at each of his President’s Nights in the 12 Ohio zones starting in late August. Contact your Zone Governor for details or email the OOA.

The ICD-10 transition is only two months away –   October 1, 2015.  Are you ready?

Steps You Can Do to Prepare for ICD-10

Following are steps that optometric practices can take to prepare.  The key is to start now (see Additional Links and Resources below for specific timetables for ICD-10 transition).

  1. Go to the Centers of Medicare and Medicaid Services website. Here you can find up-to-date information on ICD-10, e-mail updates, webinars and links for specific provider information as well as timelines for implementation.

  1. Evaluate your current documentation. Look at your current records to see how your clinical documentation would be graded in ICD-10.  Remember, the purpose of ICD-10 is to more accurately describe each patient’s condition. Documentation is what drives coding.  Is the history you documented comprehensive enough to fully describe the encounter which will go along with your findings?  One helpful tip would be to practice and improve on your everyday documentation which is driven by each clinical condition.  This will allow you or your coder to have enough information for ICD-10 classification.
  2. Determine who in the office will be affected. Evaluate all aspects of your practice where ICD-9 is currently used.  Examples include authorizations, pre-certifications, physician orders, medical records, superbills, EHR systems, coding manuals and public health reports.  Discuss ICD-10 with key staff members.  Make sure all systems you integrate with are ready to go on October 1, 2015. Allow every affected individual ample time to understand these changes and provide the necessary training.
  3. Know your top codes. There are several programs, websites and services available to help navigate the new ICD-10 codes and allow a comparison to ICD-9.  Look at the current top 10 or 20 ICD-9 codes used in your practice and find out what the ICD-10 codes will be.  These same programs will also allow you to compare ICD-10 codes to their previous classification.  Document these codes as a guide to improve accuracy when ICD-10 comes around.   A main difference will be the greater specificity of these various diseases and condition.  Examples:

Although it sounds overwhelming, taking the time to prepare ahead of time will save some stress on October 1, 2015 when the change must occur.  Encourage doctors and staff in your practice to concentrate on medical record documentation that will help choose the correct code when necessary.

Available ICD-10 Resources:

There are many resources available to prepare your practice for ICD-10 available on the Center of Medicare and Medicaid Services website.  The following links provide useful tools to guide your practice as you e transition to ICD-10.

– American Optometric Association

An optometry focused ICD-10 webinar series provides thorough and accurate information. AOA members who have an ICD-10 question that is not answered in AOA resources can direct a question to AOA’s coding experts.


– CMS Provider Resources

o   FAQ:  ICD-10 Transition Basics

o   ICD-10 Transition: An Introduction Fact Sheet

o   ICD-10 Basics for Medical Practices

o   ICD-10 Basics for Payers

o   The ICD-10 Transition: Focus on Non-Covered Entities

o   Checklists, Timelines, and Implementation

o   Implementation Planning

o   Communicating About ICD-10

o   Medscape Education:  Webinar and Articles Available


– American Association of Professional Coders –