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Adam S. Wenick, MD, PhD, discussed myopia interventions across the lifespan at EyeCon 2024, covering treatments, complications, and prevention strategies.

EyeCon 2024: Myopia interventions across the lifespan

At EyeCon 2024, Dr. Adam S. Wenick led a symposium on geographic atrophy, covering diagnosis, FDA-approved treatments, and key clinician considerations through case presentations by Dr. Leonard Messner.

EyeCon 2024: New treatments in geographic atrophy from detection to intervention

Nicotine, when administered either as an intravitreal injection or a topical eye drop, significantly inhibited the development of experimental myopia,

 according to a team of Australian investigators led by Kate Thomson from the Centre for Research in Therapeutic Solutions, Faculty of Science and Technology, University of Canberra, Canberra, Australia.

This research builds on their previous experience in which they found that stimulating nicotinic receptors can inhibit experimental myopia. They made this observation during an investigation of the mechanism by which atropine inhibits ocular growth. Their study currently under discussion expands on that preliminary finding and investigates the safety and efficacy of nicotinic stimulation in the inhibition of ocular growth.

The researchers investigated the ability of nicotine to prevent form-deprivation myopia (FDM) both when chicks were either injected intravitreally once with nicotine (9 chicks per group) or nicotine was applied topically (6 chicks per group) in 3 doses. The researchers also investigated the ability of nicotine to inhibit lens-induced myopia (LIM) in 12 chicks.

The ocular safety of the treatments was evaluated after 4 weeks of topical nicotine treatment with nicotine (n = 10), by evaluating the pupillary reflex, intraocular pressure, corneal curvature/thickness, lens thickness, retinal health (retinal thickness/cell apoptosis), and retinal function (electroretinogram recordings). In addition, they examined the effects of nicotine on non-ocular autonomic functions in both chicks (n = 5) and mice (n= 5).

 < 0.05) to a similar degree to that seen for FDM. Although ocular health was mostly unaffected by nicotine, it significantly inhibited the development of FDM in chicks both when administered as an intravitreal injection or in topical eye drops (

< 0.05 for both comparisons), albeit not in a dose-dependent manner; the highest topical dose induced an unexpected temporary reduction in cardiorespiratory output (

The investigators concluded, “Nicotine, administered as an intravitreal injection or topical eye drop, significantly inhibited the development of experimental myopia. Although the anti-myopic effects observed presently are interesting, the well-reported side effects and addictive properties of nicotine would preclude its clinical use.”

Thomson K, Karouta C, Ashby R. Administration of nicotine can inhibit myopic growth in animal models. 

Nicotine inhibits myopic growth in animal models

The Vision Council frequently releases research surrounding trends in various facets of the eye care industry, and Vice President of Research and Insights Alysse Henkel shares some highlights of recent reports.

VEW 2024: Insights from The Vision Council

At Vision Expo West 2024 in Las Vegas, Nevada, Alysse Henkel of The Vision Council shared some key takeaways from recent research published by the association. Topics included consumer behavior around eyewear labeled 

, low vision referrals and caregiver research, and practice growth trends for 2024 compared to 2023. Henkel also previewed studies regarding online behavior: Their surveys concluded that patients are more reliant on online reviews to select their eye care provider than they were 2 years ago, that they are more open to receiving an eye exam from a remote provider, and that online eyewear sales have remained steady.

I'm Alysse Henkel. I'm the Vice President of Research and Insights at The Vision Council, which is a trade or association for the optical industry. So on the market research team at The Vision Council, we develop reports and insights that are of use to our members. And our members come from sort of all over the industry. So we have everything across the supply chain, from folks who manufacture lenses and frames all the way to the eye care practitioners who, you know, do exams or sell eyewear in their offices, and sort of all of the other related eyewear accessories, or over-the-counter products as well, too.

So those are all members of The Vision Council, and the way that we develop our research is that we annually survey our members to find out what topics are sort of bubbling to the top for them and what's of interest for us to research the next year. So we always set our research agenda sort of in the fall, planning for the next year based on what we hear from our members. So sometimes they want us to sort of update research we've done in the past so we can trend it over time, and sometimes we're researching new topics that come up each year. But we do have sort of regular reports, including we do annual market estimates, like how big the industry is, how much are people spending? And then we also do a quarterly Consumer Insights study, because we run a monthly survey, and we roll those numbers up quarterly to tell people, sort of how consumers are behaving related to eyewear and eye care. And then we also have a Provider Insights that we run twice a year where we ask eye care practitioners about what's going on in their practice.

So that we recently ran a survey of US adults this summer and asked them, sort of their feelings about eyewear and just generally, what 

-labeled products mean to them. So we found out that about half of US adults are saying that they're looking for made in the USA products when they go shopping, and overall, so this is not specific to eyewear, but overall, we saw about 47% of folks saying that they would pay a premium of 6% or more for a product labeled made in the USA.

And then when we get specific to eyewear, we're kind of testing whether or not the way that the definition is developed now by the Federal Trade Commission, which is a pretty strict definition for made in the USA products, it means that all, or virtually all, materials that go into the product have to be sourced in the US. So we did some testing about whether or not they felt like, for example, like a factory that designs, manufactures, sort of does all the craftsmanship of a frame in the US, but some of the materials are imported. We asked folks if they considered that product made in the US, and we had about three quarters of American adults say that they would consider that as a made in the USA product. And then overall, we saw, again, a little more than half of consumers saying that they would, for some products, some eyewear products, pay more for a 

 label. So in particular, prescription sunglasses and safety eyewear, I think sort of we're at the top of the list of people more likely to pay a little bit more for a label that says 

So for the low vision report that we did earlier this year, we had sort of two elements about how we asked people, low vision patients, about what's going on with their diagnosis and sort of their experience as a patient with low vision. We did qualitative focus groups with two groups of low vision patients. So one with people who were low vision patients themselves, and then the other group was with caregivers of people, mostly children, with low vision. And then we also did a survey as follow up. So the focus groups were small, but the survey was large. We had a lot bigger audience for the survey, again, asking both caregivers and patients with low vision about their experience.

What we found was that about two thirds of people who had been diagnosed with a low vision condition said that they got a referral to a specialist. But we're seeing that those who had a more recent diagnosis so within the last 10 years, they're much more likely to have a referral to a specialist, at about 74% compared to people who were diagnosed over 10 years ago, they were less likely to get a referral to a specialist at about 44%. So we're seeing some progress in getting people the care that they need and sort of the specialist attention that a low vision patient warrants, but that's something that we're seeing. And overall, I think important to note for these patients is that they primarily rely on their eye care provider for information about their condition. So we have about 74% of folks saying that they rely primarily on their doctor for information. But the younger patients and like sort of younger caregivers, so patients with children who are sort of small, who have low vision issues, they're much more likely to go online to look for information about their condition.

In our Provider Insights study, which we release twice a year, we survey mostly independent practices to find out sort of what's going on in their practice with their performance. And what we found recently this year as compared to last year, that providers are telling us overall [that] they're having a little bit more of an average year. So last year, we saw, on average in 2023 about 50% of providers saying that their practice revenue was above average or excellent, and that this year, so far, we're only seeing about 30% of folks falling into that same category. So that's a 20 percentage point drop. But really the change we're seeing is that more people are saying that that, overall, the practice this year, the performance is about average. So we're not seeing declines in practices, but not seeing the same kind of growth that people were telling us they were seeing last year. So that's sort of one of the highlights as well is that inflation is still top of mind for a lot of providers, saying that it's affecting their wholesale prices, and they're having to pass that on to some of their consumers. So that's sort of another something that we're keeping our eye on, but fewer practices are saying they're having as many problems as they were last year or the year before, retaining or hiring staff.

So we have an upcoming report that we can give a little preview of. We'll probably publish that sometime early this fall. But what it is is it's a survey of US adults and finding out sort of how they behave or what kind of choices or priorities they make when they're choosing their eye care provider or when they're buying eyewear. And so what's nice about this report is that it's trended from a similar report we did 2 years ago. So we're able to sort of talk about how things have changed over the last 2 years.

And so one thing that we're really interested to see is that when folks are looking at choosing their eye care provider, that we're seeing about a 6%, so six percentage point increase, in people saying that online reviews, so like Zocdoc or Google reviews, are more important now than they were years ago. So we're seeing a little bit more of a reliance on online reviews in terms of choosing your provider.

One of the other kind of notable things that we saw in the survey is asking people about why they have an eye exam, and what we're hearing overall, this was the number one item, both 2 years ago and now, is that people say they want healthy vision, but we're seeing an increase in the number of people who are saying that. So we went from 34% in 2022, to 41% in 2024, so healthy vision is more top of mind for patients as they're coming in for an exam.

One thing we don't have trended, because we asked about this for the first time this year, was about whether or not patients had experienced a telehealth exam. So primarily, we asked if people had gone to an eye care practice and then had a provider join their exam remotely and sort of go through their exam remotely with an assistant in the room. And so we saw surprisingly, 11% of people said they had experienced an exam like that with their eye care provider. So that was a higher number than I would have expected, because primarily, we've been asking people, from the telehealth perspective, if they were at home and then video conferencing with their eye care provider, and we've seen that number be really low for a long time, ranging between 1% and 3%--it was 3% in this most recent survey. But that 11% sort of seeing that remote exam, was interesting to us, especially because we've also been hearing sort of anecdotally from some of our members about how difficult, in some cases, it is to hire optometrists for their practice, especially in more rural or remote areas, and this is one solution that they're looking to and so it looks like patients are experiencing that. We also asked people who haven't had that kind of exam if they would be willing to engage with a remote provider, and about half of participants said they would be willing to have an exam like that.

So one of the things that I think has been surprising of late in our data is that we have run a consumer survey very consistently back to 2022 to sort of track changes over time. And one of the things that we've seen over the last couple of years is that the online purchase rate for eyewear has been really steady. So it's been almost exactly 16% each month, with the exception--because we saw sort of an increase during Covid[-19 pandemic], and then it's ramped down a little bit since 2022. But what we've seen this year is like a 2 or 3 percentage point decrease, so almost like 1 percentage point per quarter so far this year, where fewer people are buying their eyewear online. So I think that's sort of an interesting trend. I think that people often assume the trend is going in the other direction. So, you know, overall, it's still about 1 in 6 eyewear purchases for prescription eyewear are happening online, but really the market is very much still in person. And actually the in-person market is growing a little bit.

Yeah, so I think overall, I just want people to sort of understand the wealth of information that we have at The Vision Council. So not only do we have sort of a research download center on our website, just packed full of reports that are free to our members, but we also have a Foundation website, so thevisioncouncilfoundation.org, where we also publish highlights from some of our research that's available to anyone. So I think that's those are, you know, some takeaways that people can sort of go in and see for themselves about the kind of data that's available. And we're also always looking for people to join our research panel and answer our survey questions at eye care practices about what's going on.

Conference

Avanzanite Bioscience has announced that the European Commission (EC) has approved a marketing authorization for Akantior (polyhexanide) for the treatment of acanthamoeba keratitis (AK). After 16 years of research and development, the monotherapy eye drop is now the first and only authorized medical product for the treatment of AK in the world, according to a news release.

The marketing authorization from the EC follows a positive opinion from the European Medicines Agency’s (EMA) Committee for Medicinal Product for Human Use and a recommendation by the EMA’s Committee for Orphan Medicinal Products. The solution will be targeted for both adult and pediatric patients 12 years and older who experience AK.

The positive opinion was based on findings from the pivotal Phase 3 Orphan Drug for Acanthamoeba Keratits (ODAK) trial, which included 135 patients. The trial found that almost 85% of patients treated with Akantior were cured, with almost 67% achieving full vision restoration. No patients involved in the study required an optical cornea transplant, and 7.5% required a therapeutic cornea transplant.

"Our studies have shown that with Akantior, when used as monotherapy following the treatment delivery protocol established during the trial, medical cure rates of over 85% can be achieved," said John Dart, MD, FRCS, FRCOphth, principal investigator of the ODAK trial and professor at the Moorfields Eye Hospital and the University College London Institute of Ophthalmology, in the release. "As the first authorized drug for AK, I expect this to become the standard of care for this severe disease."

Akantior is an anti-amoebic polymer formulated at a high 0.8 mh/ml (0.08%) dose strength and is administered in single-dose containers. According to Avanzanite, the eye drop has treated to more than 200 patients across 12 countries through a pre-authorization distribution program. Next steps for the company include collaborating with local health authorities in 26 European countries in order to obtain sustainable access agreements.

AK is a rare and severe parasitic corneal infection caused by Acanthamoeba, a free-living amoeba. The disease primarily affects contact lens wearers and can lead to blindness and, in extreme cases, the loss of the affected eye. Formerly, compounded or off-label therapies were the only treatment options for AK, which often required multiple cornea transplants with low graft survival rates, according to the release.

"No one fighting such a devastating rare disease should be left behind. This marketing authorization is the beginning of a new chapter for the treatment of AK and a monumental victory for AK patients in Europe," said Avanzanite Founder and CEO Adam Plich in the release.

Avanzanite Bioscience Reports European Commission's Authorization of Orphan Medicinal Product AKANTIOR®. News release. Businesswire. August 27, 2024. Accessed August 30, 2024. https://www.businesswire.com/news/home/20240826744342/en/Avanzanite-Bioscience-Reports-European-Commissions-Authorisation-of-Orphan-Medicinal-Product-AKANTIOR%C2%AE

Canonical

European Commission grants marketing authorization for acanthamoeba keratitis treatment

Dr. Brianna Rhue gives an overview to optometry's new speciality myopia management

VEW 2024: Debunking myths in order to integrate myopia management into your practice

Before integrating myopia management into your practice, Brianna Rhue, OD, FAAO, FSLS, advises that your passion in the speciality should be serious. She gives her suggestions on where to start in your quest for myopia management integration in your practice at the 2024 Vision Expo West conference with her presentation, "Myopia Control". The presentation was given alongside Milton Hom, OD, FAAO.

This transcript has been lightly edited for clarity.

Hi everyone. I'm here with Dr Brianna Rhue who is here to discuss her Vision Expo West presentation with Dr Milton Hom on myopia control. So thank you so much for taking the time to chat with me today.

Thank you, Emily. I'm excited to share one of my passions which changed my practice and the lives of my patients.

Yeah, so first, can you tell me a little bit about your presentation on myopia control?

Yeah. So it's still fairly new, this whole myopia control, myopia management arena in the eye care space. So just having our first FDA approved treatments come in 2020 there's still a lot of myths that we need to debunk. So we're going to be sharing some studies around it, some case studies that we've done in our own clinics, really get into the treatment protocols and then also follow up with some implementation to bring it back to your practice and start practicing to a higher standard of care with your myopia patients.

Fantastic, and for somebody who has not yet dipped their toes into myopia and is a little bit nervous about it, where can they get started?

Come over here, it's so much fun. So it starts with knowledge, which is really what Expo is really good at. So getting the CE requirements, seeing people that are doing it, getting those questions answered. So how this presentation is made was I went to a conference that was 4 days long, and I came back and I was like, "Oh my God. I just wish they would have said this, because then I would have gotten it so much easier." So it's like 4 days of a conference condensed into an hour and 40 minutes, or a 2 hour presentation on just top level what do you need to know, why you're doing it, and then go for it.

I know you mentioned that myopia control has changed your practice. Can you tell me a little bit about your personal experience with myopia control?

Yeah. So we're taught in school to find your niche, find your niche, find your niche. That was just eating my brain. I graduated in 2009, I did my residency in 2010, I joined a private practice. Here comes 2015, and I was just like, "Oh, my God, is this what I have to do the rest of my life, which is to say, '1 or 2'?" I can count to 8, so it's got up to 8.

But when I was pregnant with my first son, who is now 8, being a high myope myself, marrying a high myope with my husband, I just did a random search on what can we do to slow down myopia. I realized really quickly how far away from the rest of the world we were in implementing strategies to help patients not have to live a life as a high myope. Really, when you hit that -3 is really like you're now dependent on your glasses. Really about a -2.50 and you're dependent on your glasses. So if we can catch kids earlier, do that together with FDA approved treatments, your parents and your patients will come in asking this.

So I will give a warning here. If you do not want to do myopia management, don't start it, because it is a weed in your practice that will grow and grow and grow and grow and it will start to take over your practice, which is what I wanted. I wanted something better. I wanted something that I could get behind that I was passionate about. So if myopia is not your jam, that's okay. Maybe it's glaucoma, maybe it's dry eye, maybe it's esthetics, maybe it's pediatrics. So just be true to yourself, be true to your passion, and then that's where your patients feed off of that, and that's where you feed off of them.

Yeah, absolutely. And so myopia has been such a hot topic in the optometric industry. It is a huge buzzword right now because everybody's talking about it, which is fantastic, but the messaging can get kind of lost in the noise. But if you could distill it down even further into the top 3 things that everybody should know about myopia control, what would you say that they are?

Yeah, top 3 things are you already have a myopia clinic, just go after it. Even before Vision Expo, if you're watching this after Expo when you go back, 70% of the patients that you're going to see that day are myopic. So you already have it now, you just get to plant those seeds and figure out what it is. Understand the treatments. Right now in the US, you have atropine, you have your dual focus lenses, and you have ortho-k. So MiSight from CooperVision, which is FDA approved, you have the Abiliti lens which is ortho-k. I want to debunk some myths around ortho-k because it's all topography-based, and it is just a game changer for your practice and your patients. And then atropine. Atropine getting a lot of slack right now because of the unknown. There's no unknowns really here anymore. There's a few not saying that there's not. But it's very safe, it's very effective, and we have, hopefully, some treatments that will be approved soon. 

They have spectacles that are coming. I think spectacles are not the way. We want to give our kids freedom. We want to be the advocate for our kids. I was a young myope, so got my first pair of glasses in second grade. Got my first pair of contacts in third grade. Thank God to my mom pushing the doctor, and it just changed my perspective. I was timid, now I have these big purple glasses on. That doesn't work. So just the freedom it gave me, don't wait for spectacles to be the saving grace here. That's not the answer. It's part of the equation. But there's other things that you need to do to advocate for your patients.

Yeah, absolutely. I mean, it's always going to be about what's best for the patient in your chair, and not necessarily 1 cure-all that's going to be good for everybody. So I know that you're also doing a presentation about myopia, dry eye, and ocular esthetics. Can you tell me more about that event?

Yeah, so Thursday night, my cofounder of Dr. Contact Lens Jennifer Tepiza and myself, we're hosting a dinner for 100 doctors. We have just a few slots left on really the implementation. So these hot topics: dry eye, esthetics, myopia management. The education piece of it is a big piece of it, right? You have to learn how to talk about it. You have to learn just questions and be prepared for questions that, shoulders back, you're confident that you're providing care. Then there's another pillar, which is implementation. And we don't spend a lot of time there, so that's what this dinner is going to be. So we've got 13 awesome sponsors in the industry that are going to be there, also supporting us and just a good time. Dinner, cocktails, and learn how to take care of your patients and take care of your practice so we can keep going back to Vegas.

Yeah, absolutely. Is there anything else that you want to touch on that we haven't talked about yet?

I'm excited to see everybody at Expo. Again, lean into your exhibitors. They are there to support you 100%. Ask better questions. Don't go in asking what something costs. Ask what the investment is, how it's going to better patient care, how the support is going to be. They're there to partner with you and that's where we get education in the Education Hall and we get way more education in the Exhibit Hall. So when you're walking out of education, go to the Exhibit Hall, because I see education getting out and everybody swarms away from the exhibit hall, and I'm like, "You're going the wrong way!" So there's my shameless plug for all of our vendors.

Alright. Well, thank you so much for taking the time to chat today, Dr Rhue. This has been absolutely wonderful. It's always wonderful to talk to you about myopia control.

My pleasure. Thanks, Emily. See everybody at Expo.

Brianna Rhue, OD, FAAO, FSLS, shares her passion for myopia management and control at this year's Vision Expo West.

Growth Factor Supplementation: A New Paradigm in Ocular Surface Disease Management

Growth factors play a crucial role in maintaining ocular surface homeostasis and health and promoting healing in various ocular disorders. As our understanding of these molecules evolves, so does their potential for therapeutic application. To explore the current state of knowledge and clinical practice regarding growth factors in ocular surface disease, Vital Tears recently convened a roundtable discussion with five internationally renowned clinicians specializing in dry eye and ocular surface disorders: Clara Chan, Minas Coroneo, Pedram Hamrah, Victor L. Perez, and Stephen Pflugfelder.

Sponsored Resources

The expanse of land that the Ohio State School for the Blind (OSSB) in Columbus lies on is teeming with life, bringing serenity and peace of mind to its students. With both OSSB moving and the Ohio School for the Deaf (OSD) expanding to its location on Morse Road in 1953, the schools reside less than 2 miles apart from each other, with Bill Moose Run splitting the middle of the land as a protected nature preserve.

Gregory Hopkins, OD, MS, FAAO, extern coordinator at OSSB and clinical associate professor of practice for The Ohio State University College of Optometry in Columbus, said he finds that the nature surrounding the school and the students have more in common than they have differences. “When I’m up there, there’s always wildlife around, and you can hear the birds chirping. They have a sensory garden out in the front,” he said. “It’s interesting to be out there because it’s very immersive. I think of each of these kids being like a rare bird.”

It is the broad diversity of OSSB students’ eye conditions that makes each patient who Hopkins serves unique, he said. Every Wednesday, he leads optometry students in eye examinations of no more than 6 patients a day to ensure that each of the approximately 100 OSSB students receives routine eye examinations or complete workups when necessary. He estimates that of these students, approximately a quarter have conditions caused by early birth, such as retinopathy of prematurity, and another quarter have some form of optic nerve atrophy.

“That leads half of them to [have] a complete and total grab bag of different conditions, and some of them have very important systemic implications,” Hopkins said. Some of these rare conditions and diseases include choroideremia, syndromic retinitis pigmentosa, albinism, and Leber congenital amaurosis.

Although each student’s visual acuity and eye condition may be different, Hopkins said it is nearly impossible to assume what each student’s visual acuity may be from a glance. “The difficulty with vision impairment, just like other conditions, is [that] it’s a spectrum,” he said. “The irony is that their visual acuity is invisible to onlookers. I can look at 2 kids’ class photos from OSSB in the yearbook and not know which of them can see better than the other just from that, so this requires very individualized care.”

In order to keep medical records fresh for quality patient care and help secure federal quota funding, Hopkins said each student at the school has a comprehensive eye examination at least every 3 years. These examinations are done to the level of the patients’ visual ability (eg, if a patient has had an eye removed, infections and allergies can still be checked for). For new students who transfer in, Hopkins said these examinations are usually longer, running from 1.5 to 2 hours. He estimates that the average visual acuity of OSSB students is 20/200.

Hopkins said a part of the routine care that he provides to his patients also includes conversations about their conditions for the sake of transparency and planning for the future. “Some of the work I do there is talking to the kids about what the odds are that they may get some genetic therapy or cures in their life. Or sometimes there’s a kid who was mainstreamed and [had] some kind of trauma or tragic loss of vision, and now they’re just trying to completely retool,” Hopkins said.

Examinations for nonspeaking and blind or deaf students can prove to be a challenge but are made easier by the proximity of OSD, according to Hopkins. “Being so close to [OSD] and having developed a reputation for doing decent work, I get more patients coming over from there, and to do an examination through an American Sign Language interpreter [for] a kid who has impaired vision is probably one of the hardest styles of examinations that you can attempt to do,” he said.

Additionally, because students either live on campus or take the bus to school every day, Hopkins said providing comprehensive care without the parents present is also challenging, despite efforts to connect via Zoom. “Imagine if I sent one of my kids into the doctor’s office and they had to rely on them for everything. It’s tough, so I try to get around that by getting access to the medical records at children’s hospitals,” he said.

Ultimately, Hopkins said that these efforts to provide individualized care contribute to OSSB’s ability to put its students at ease and help them feel welcome. “For each kid, the determination is made that this would be the least restrictive learning environment for them, and a lot of them are super happy to be there because they don’t have to explain themselves to other people 10 times a day,” he said. “Everyone there just gets it.”

OSSB is the oldest school for blind individuals in the nation and is just one of the more than 50 schools and agencies in the US registered as members of the Council of Schools and Services for the Blind that serve children with visual impairment. According to a 2023 annual report from the American Printing House, almost 55,000 students with blindness or low vision were registered under the annual Federal Quota Census, with 4539 (8%) registered through schools for the blind.

 This percentage has remained steady since 2016.

As far as employment rate after completing school, findings from one study in 2019 estimated that approximately 44% of the population with a visual impairment are employed and that 10% of people with a visual impairment who are in the labor force are unemployed.5 Hopkins said that although OSSB provides a postsecondary program to help with the transition into the workplace with internships and vocational classes, it can still prove difficult for alumni to find their footing. He added that having OSSB on their transcript may even work as a detriment to finding adequate, full-time work. “Most of them are unfortunately not being offered full employment at the level that they would hope, so that’s why we try and have these safety nets,” Hopkins said.

Set up for success at Cleveland Sight Center

With a small portion of students with visual impairments enrolled in schools for blind individuals, the large majority experience a different learning environment through the public school system. More than 43,000 students with visual impairments were registered through public schools in 2023.

 As many as 90% of high school students with blindness or low vision attend their neighborhood’s public school, according to Mobility International USA.

For young children entering the public school system, the transition can prove difficult for both them and their family. To help ease this transition, Cleveland Sight Center (CSC) in Ohio is one of the country’s nonprofit organizations that provides early intervention services for children from birth to the age of 3 years. According to Laurie Zebrasky, MSW, manager of early childhood services at CSC, the organization has 5 staff members who provide direct services at home for approximately 250 families across 7 counties every year.

Because CSC is involved in these children’s lives during some of their most formative years, Zebrasky said their care plans are constantly changing to best fit their needs. “[Early intervention specialists are] giving that parent information, the knowledge, the tools, the skills that they need to be an advocate for their own child, to help them understand their own child’s diagnosis better,” Zebrasky said. “All that preparation that we’re doing over those couple of years, if we have them that long in early intervention, is also helping to shape them and prepare them for what we call that transition to preschool.”

Zebrasky added that this also includes a timeline for how long resources and support are provided to a given family through CSC. “If the child turns 3 [years] in May, they’re not going to get special education preschool services until September, and they’re a child [with] very high need[s], we can still go out and make a couple of visits over the summer,” Zebrasky said.

Optimizing the child’s living space depends on many different factors, including reducing visual clutter and determining the physical location for light sources, according to Barbara Williams, MEd, CSC’s early intervention specialist and team lead. Improving a child’s ability to navigate their living space also requires an assessment for the child, which includes functional vision assessments and evaluating orientation and mobility. “When we’re assessing, we really tease out, how does the child respond to things like color and complexity, and do they respond more on one side than the other?... It’s a matter of observing the child, interacting with the child, and getting information from the parent or caregiver, because they’re the ones who know the child the best,” Williams said. To better understand a child’s visual acuity, Williams said CSC also works with an optometrist to walk the team through eye reports and specific visual conditions.

In terms of referrals, Zebrasky said the organization is working to improve their relationships with local eye care providers to help streamline the process. She emphasized that children do not need to have no light perception or have legal blindness to benefit from early intervention services. “Doctors generally only make referrals for the most severe cases,” Zebrasky said. “I would love to be able to grow the communication.”

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https://www.aph.org/app/uploads/2024/02/APH-Annual-Report_FY2023-accessible-UA.pdf

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McDonnall MC, Sui Z. Employment and unemployment rates of people who are blind or visually impaired: estimates from multiple sources. 

High school placements for blind and low vision students. Mobility International USA. Accessed August 16, 2024. 

https://www.miusa.org/resource/tip-sheets/highschoolplacements/

From schools for blind individuals to early intervention services, families have options to help prepare their children with visual impairments for adulthood.

Adam S. Wenick, MD, PhD

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