The bill, proposed by Sen. Michael Moore of Millbury would expand the current requirement for a recent eye exam for children entering kindergarten to those entering preschool.
When a child is unable to follow the teacher’s instructions or actively participate in class, it may be a behavioral health problem or simply because the child can’t see the chalkboard. They struggle in the classroom unless teachers and parents are aware of their vision issues.
A legislative proposal aims to ensure no child falls behind due to lack of access to basic vision care by expanding children’s vision screenings as well as follow-up care.
The bill, proposed by Sen. Michael Moore, D-Millbury, and Rep. Christine Barber, D-Somerville, expands the current requirement for a recent eye exam for children entering kindergarten to those entering preschool. It also establishes a vision and eye health advisory council and a computerized registry to record screening results.
Certain vision disorders have a significant effect upon children’s ability to read, like hyperopia, also known as farsightedness, that makes it difficult to see up close. Another disorder, astigmatism, causes distorted vision and affects reading clarity, said Bruce Moore, a leader of Children’s Vision Massachusetts and professor emeritus at New England College of Optometry. Lack of reading skills will cause significant deficits in education.
“Therefore, a child is more likely to end up in special education that costs cities and towns two to three times as much money as typical education,” Moore said.
Early screenings can help detect vision problems before they worsen. Eye diseases like amblyopia, or “lazy eye,” are far easier to treat at age three than upon entering school, Moore said. Amblyopia affects approximately 2–4% of children in North America, which means it is common to find one kid with the condition in each classroom.
Only 60% of children on public insurance in Massachusetts had their vision screened and 70% of children on private insurance, according to the 2021 Report of the Childhood Vision and Eye Health Commission by Massachusetts Department of Public Health.
Finding a pediatric optometrist for follow-up care could be difficult in communities facing a lack of access to vision care. Around a decade ago, Dr. Moore had his students call eye doctor offices in Springfield to ask if they could make an appointment for a child on Medicaid.
“We found only a handful of eye doctors that would even think about seeing that child,” he said. Medicaid’s low reimbursement rates contribute to longer waiting lists.
Parents in eye care deserts have to take time off to get their children to eye care providers, which places a heavy burden on families that do not have a car or cannot afford unpaid leaves, said Amie Shei, president of the Health Foundation of Central Massachusetts. She has heard stories of parents waiting for months, even a year. Students continued experiencing challenges seeing in the classroom while waiting.
Southbridge is one of Central Massachusetts cities experiencing a lack of access to vision care. In 2024, the Vision for Southbridge program provided free eye exams and glasses at no costs to students in need by a mobile vision clinic at Southbridge public schools. But it was a one-time program, Shei said, which highlighted the need for more sustained resources for children who fail vision screenings.
Not every child has access to follow-up care, even when it is as basic as wearing proper glasses. MassHealth provides one pair of glasses each year for children. If they lose or break their glasses, low-income families cannot always afford a new pair for them, Shei said.
“This is an area where the sooner you know about a potential issue, the more that can be done early on, that can prevent worse outcomes in the future.”