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Eyeglasses: Peering Into Educational Dysfunction

If you wear reading glasses, please take them off for a moment and continue reading this blog.

You can't? You won't? Well, now put yourself in the position of a child in a high-poverty school who needs eyeglasses but does not have them.

In the richest country in the world, it is shocking, but it is a fact that a very, very large number of disadvantaged children who need glasses don't have them. A New York City study of middle school children found that 28 percent of them needed glasses, and less than 3 percent had them. Studies in Baltimore-- including the Baltimore Vision Screening Project in the 1990s--and many other places find the same.

The eyeglasses story varies from place to place, but here's how it works. In most schools, the health department screens for gross vision problems. If children are found to have problems, parents are asked to take the child to an eye care professional for more testing, a prescription, and then glasses. In middle class families this usually works, but in disadvantaged families, plenty goes wrong. Overburdened health departments may not actually do screening, or may do it at rare intervals. Parents may not be able to afford eyeglasses; Medicaid provides funding for them, but this takes a lot of paperwork. Parents may not follow up, finding it difficult to take off from work. Even if they do get glasses, kids being kids lose or break them, and the whole process begins again, or doesn't. Schools with particularly relentless staff focused on this issue can get much better percentages of kids with glasses, but it's a struggle.

Because kids' vision is more flexible than that of adults, most kids can see an eye chart. However, for many, focusing on text takes more effort and concentration than it does for kids who have or don't need glasses, especially as text gets smaller past the primary years. The result is that these kids lose motivation, or come to think they are stupid. As an adult who wears reading glasses, I can read most type without my glasses, but I don't want to do it very long. However, I know I can read and how to fix my problem. A kid in Chicago or Biloxi may not know that others can see, or that he or she could be learning to read.

The failure to get eyeglasses on disadvantaged kids illustrates broader, uncomfortable truths about education policy. This is a really, really simple problem. A pair of glasses can cost $20. Yet schools do not see eyeglasses as their problem. They see it as the Health Department's problem, or the parent's problem, or both. Yet schools are ultimately responsible for kids' reading, and even in the narrowest economic analysis schools are spending vast resources on tutoring, remediation, and special education for kids who can't read, some proportion of whom merely need $20 glasses.

There are simple and cost-effective solutions to these problems. Making schools (rather than health departments) responsible for vision and funding them for this purpose, or at least letting them use Title I funds for eyeglasses, could help a great deal. Schools could keep sets of glasses for use by children who need them. Proactive screening and relentless follow-up could make the current system work better. But what's lacking is a sense of outrage and real accountability. Here are children failing for an entirely preventable reason. If you took off your reading glasses at the beginning of this blog, put them back on and read it again. Doesn't this make you see red?

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