August 22, 1997

Tennessee Lions Eye Center ready to shine

Tennessee Lions Eye Center ready to shine

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During a recent visit to VUMC, Lions Club member John Justice looked on as Dr. Sean Donahue tested the sight of six-year-old Aaron Simon. (photo by Donna Marie Jones)

When the Tennessee Lions Eye Center at Vanderbilt Children's Hospital celebrates its official grand opening on Saturday, Aug. 23, one of the programs highlighted will be a special outreach initiative to screen pre-verbal children across the state for eye problems that may go undetected at such an early age.

The 'clinic without walls ' is a screening program that uses high-tech camera equipment to photograph a child's eyes. The special cameras, called photoscreeners, will be operated by trained Lions Club volunteers throughout Tennessee.

The photographs will then be digitized and transmitted to a "reading center" that will be located at VUMC. At that point, the photographs will be examined by physicians to determine if there may be a problem.

"We can reach out to all of the children of Tennessee and provide vision assessment if they don't have access to other physicians," said Dr. Sean P. Donahue, assistant professor of Ophthalmology and Visual Sciences. "It will allow us to detect problems that otherwise might go undetected in the eyes of very small children."

Donahue emphasized that the program is not intended to specifically diagnose a problem, but to determine if there is a need for further evaluation.

"Children who need further evaluation will be sent to local ophthalmologists or optometrists or to Vanderbilt for a full examination," Donahue said, adding that the photoscreening technique is 85 percent to 90 percent accurate in detecting serious eye conditions.

Estimates are that about 3 percent of children in Tennessee have some type of eye problem other than the need for glasses, Donahue said, explaining the need for screening of this type. Common problems include amblyopia (lazy eye); strabismus (misaligned eyes); and congenital cataracts. Other vision-related problems commonly diagnosed in children include congenital glaucoma and abnormalities of the retina, the light-sensing portion of the eye, which may occur due to premature birth.

There are 1.2 million children in the state and only 10 pediatric ophthalmologists ‹ three of whom are at VUMC.

The screening program is specially designed for preverbal children because once a child can read an eye chart, problems are easily detectable in a primary care physician's office, Donahue said, adding that patients who never see physicians also never get detected.

The photoscreener is an off-axis camera that makes use of the light bouncing off the eye when the photograph is taken. The camera light, instead of being shone directly into the eye, like a camera flash, is off-centered, he said.

"The camera light is shone at two different directions 90 degrees apart," he said.

Initially, the photographs will be taken at preschools, day care centers, health fairs, or upon request, Donahue said. Details of the program are still being worked out. It will begin locally, then will expand statewide within a few months.

Two medical students, Carolyn Quinn and John Parrott, both first-year medical students who are involved in the community scholars program begun this year at Vanderbilt University School of Medicine, are currently coordinating the screenings.

"The nice thing about the program is it doesn't matter if you're a block away or 200 miles away. The technology allows the screening to be done easily," Donahue said.

Dr. Denis M. O'Day, George Weeks Hale professor and chair of Ophthalmology and Visual Sciences, said the outreach program is just one part of what the eye center will offer to patients in Tennessee.

"This is made possible by a real partnership between the eye center and the Lions of Tennessee. We want to be able to reach the entire state and help children have good vision."

O'Day said the Tennessee Lions Eye Center is a "unique arrangement that is unbelievably grand." The pediatric eye clinic at VUMC presently is able to accommodate about 4,000 children a year.

The new clinic area is "child friendly," O'Day said. Examination and testing rooms are designed especially for children and are equipped with state-of-the-art diagnostic equipment.

"It will be like nothing in this region," O'Day said.

Plans for the new center were announced in December 1995, when the Lions Clubs of Tennessee launched a statewide campaign to raise an estimated $4 million to support the clinic.

The Lions Clubs and VUMC have a 30-year history of collaborating to provide eye care to indigent adults through the Middle Tennessee Lions Sight Service as well as the Lions Eye Bank, which provides corneal tissue for transplantation. The extension of this partnership to pediatric eye care is a natural progression, O'Day said.

He also said the continued delivery of proper vision care is vital to a child's future.

"In many ways, good vision helps determine a child's development and his or her success and independence in adulthood," O'Day said. "Good vision is central to the quality of life. Nowhere is this more evident than in children. In the absence of clear, accurate vision, normal development ‹ walking, playing, social interaction and reacting to colors, shapes and other stimuli ‹ is impaired or delayed. Such delays can contribute to a lifelong pattern of poor classroom and job performance, poor social adjustment and low self-esteem," O'Day said.