A Clearer Vision

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By Kendra Ablaza, Orange County Register Writer

A free screening is among efforts in O.C. to get youngsters’ eyes checked.
Waiting for a child to speak up could be too late, one expert says.

Rayden Feghali, 3, of Irvine flashes his pirate face during a vision screening, as his mom Marcella, and grandpa Fouad Feghali, watch. The free testing for infants and preschoolers was sponsored by the Better Vision for Children Foundation.
Rayden Feghali, 3, of Irvine flashes his pirate face during a vision screening, as his mom Marcella, and grandpa Fouad Feghali, watch. The free testing for infants and preschoolers was sponsored by the Better Vision for Children Foundation.

Rayden Feghali, 3, held on tightly to his Disney light-up glow sword. He was unsure of what the camera in front of him was doing. Then he caught a glimpse of his face on its preview screen – his eyes were lit up bright orange.

He smiled and so did his mother, Marcella Feghali. For her, it was a sigh of relief. “I was crossing my fingers hoping they were normal,” Feghali, 27, said about her son’s eyes.

The Irvine resident had her son take a free vision screening test on Saturday aimed at infants and preschoolers.

Tom Cataldo, founder of the nonprofit Better Vision for Children, hosted the all-day screening at Cailber Motors Mercedes-Benz of Anaheim. He said screening the eyes of children younger than 5 for physical problems is crucial, and the earlier it is done, the better.

He had seen a handful of children in the first two hours.

“Blockages like tumors and cataracts have to be dealt with before age 5,” Cataldo said. “If you have cataracts in both eyes, they can create irreversible blindness for life.”

Cataldo, who is legally blind, invented a camera device 27 years ago used for photorefractive vision screening.

"...not catching and correcting serious disorders and diseases within the first few years of life, can cause autism, lifelong blindness, and, in the cases of eye cancer, loss of life"
“…not catching and correcting serious disorders and diseases within the first few years of life, can cause autism, lifelong blindness, and, in the cases of eye cancer, loss of life”

His camera shines its flash into its subject’s eyes, capturing a photograph to detect how the eyes focus and a number of other issues, from common problems as near- or far-sightedness and astigmatism, or more serious, even life-threatening issues, such as lazy eye, cataracts and tumors.

He started his screenings in Baja California, then spent decades in San Diego before moving his organization to Anaheim Hills two years ago. Cataldo said Orange County is in strong need of a larger network of vision care accessibility and awareness.

“People tend not to go too far from where they live when they want to do something like this,” he said. “I am not impressed by the availability of physicians- pediatric ophthalmologists- for these problems.”

Kelly Pijl, external affairs director with the Children & Families Commission of Orange County, said it set aside $1.5 million gained from Prop. 10 for pediatric funding, and is collaborating on a new pediatric vision program for the county with Children’s Hospital of Orange County, UC Irvine, UCLA, UC San Diego, and UC San Francisco.

The commission, which focuses on health and school readiness for children through 5 years old, was presented with a formal report on children’s vision care in the County Wednesday. It will meet with its partners in November to go through recommendations for the new vision program focused only on children under 6.

“The program is in its initial stages,” Pijl said. “Recommendations are to commission in the next couple of months, which would help decide formal action.”

Natalie Gerdes, a registered nurse for Newport Mesa Unified School District, also felt the need for more attention to pediatric visual health this year. She understands how important it is for children to be screened young, and is counting on a new county program to improve the use of screening technology in Newport Mesa preschools.

“That can make a huge difference in a child’s life, in general daily learning experiences and academically,” Gerdes said. “They might have trouble focusing in school, and problems go on for too long until there is nothing we can do about it. We have to identify those symptoms early for intervention.”

She said part of the issue had to do with access to technology. While there is new technology on the market, the items that schools use might not be up to date.

Another part of the issue was giving parents a clear route after their child had a screening.

"To have access to screening and a system in place to refer them to for care would make a huge difference. It's a huge leap forward"
“To have access to screening and a system in place to refer them to for care would make a huge difference. It’s a huge leap forward”

“To have access to screening and a system in place to refer them to for care would make a huge difference. It’s a huge leap forward,” Gerdes said. “Children with special needs in particular have a challenging time accessing care.”
According to the 2010 U.S. Census, 231,218 children in Orange County are younger than 6. Gerdes estimates 20 to 30 percent of the county’s preschool children have vision problems.

Dr. Robert Lingua, a pediatric ophthalmologist and health sciences clinical professor at UC Irvine, presented the pediatric vision care report to the commission. Free screenings would be most accessible for preschool-age children at some preschools or health clinics, he said. However, the quality of vision care at clinics may falter because screenings are typically labor intensive and time consuming for staff.

He also said educating families on the child’s vision can also be difficult. Often, he said parents wait until their child is verbal or cooperative, but children younger than 5 who have vision problems will not or cannot say what is bothering them.

“We all know that all children from ages 3 to 5 that are screened, 20 percent are going to fail,” Lingua said. “Six to 8 percent are in desperate vision eye correction, while 2 to 3 percent have medical or surgical problems that need a referral.”

Eye Screening
Eye Screening

Cataldo aims his screenings at low-income families. He does not treat childrent for their symptoms. Instead, he fills out a form that refers families to ophthalmologists that partner with the organization to provide lower costs. He said he makes treatment referrals for about one-third of the children he screens.

When she was waiting in line, Feghali had not thought about taking Rayden to a vision screening before that morning. She said her dad told her about the event because he gets his car serviced that the dealership.

Before Rayden’s exam, Feghali said she would monitor his vision at home or maybe take him to an eye exam at Costco. After it was over, she considered taking him to have his eyes screened every one or two years.

“It was simpler than I thought,” Fegali said. “I thought they would use more instruments.”

Orange County Register – Sunday September 8, 2013