Lehighton nurses defend school eye exams

Lehighton Area School District’s school nurses strongly defended their state-mandated eye exams at a board meeting Tuesday night, responding to board members who believe the job could be done by volunteers from the Lions Club instead.

“I respectfully ask the school board to reverse their decision to have the Lions Club perform vision screenings for K-12 in our school district. We are currently capable of completing this job on our own as we have the last 35 years,” said school nurse Colleen Harleman.

Harleman and Lehighton Area High School nurse Abbie Guardiani were responding to comments from board member Gail Maholick, who said last month that the Lions’ exam was superior to the nurses’.

The nurses said that the Lions test has its place, particularly with young children, but it is not approved by the state for mandated student eye exams.

Maholick said the Lions’ test should still be offered as an option, and board member David Bradley said that the Lions’ test is superior to the nurses’ exam.

“It would be wrong of us not to accept this generous opportunity for all our students and community members, across the community, should have this opportunity if they’re willing to help us,” Bradley said.

Guardiani and Harleman, who each have 35 years experience as school nurses, presented information comparing the two exam methods and spoke about their experience conducting eye exams in the district.

Guardiani said that the nurses in the district have combined to perform more than 56,000 eye exams over the years, and she has performed at least 28,000 by herself alone.

“When performing our eye exams, the school nurse who is trained in head-to-toe assessment uses that opportunity to see each child, as a time not just set aside for an eye exam,” Guardiani said.

The nurses said the Titmus machine they use is approved by the state for mandated annual eye exams the Lions’ is not, and the school’s has a lower cost of maintenance.

By contrast, Harleman said, the Welch-Allyn screener used by the Lions Club’s Kids Sight program does not meet the state’s requirements, and costs much more to maintain.

Harleman cited a letter from the coordinator of the Kids Sight program, who said they are primarily targeting children ages 0-6. She said the machine is designed specifically for young children and people who are incapable of reading an eye chart.

Resident Barbara Bowes said the Lions exam could be of value because it detects tumors behind the eye. She said even if the odds are slim, it could be lifesaving for a child who benefits from it.

Guardiani said that eye tumors and strabismus are more common in preschool-aged children.

“I see lots of value in it when it’s used where it’s meant to be used, which is from ages 0-6, where you’re going to be more likely to find that problem,” she said.

Guardiani stressed to the board that the annual eye exam represents much more than just an evaluation of a student’s eyesight.

She said it’s the only time that the nurses get to see every student in school.

They use the opportunity to do a “head-to-toe visual assessment” of the students for clues which may suggest a need for medical attention.

“An eye exam is not just an eye exam. It is an opportunity for a medical professional to do what we do best. It is far more than meeting a state mandate,” Guardiani said.

Bradley added that some parents may not want the school nurse to do a head-to-toe assessment of their child during the eye exam.

“I’m completely against that. I’m for personal privacy,” he said.

Guardiani defended her approach, saying it is what she and her colleagues are trained and certified to do as nurses. She said in one instance during an eye exam, she became concerned about an abnormal dark spot on a student’s ear, which turned out to be a precancerous lesion.

“Sir, I am a registered nurse, and I do head-to-toe eye exams when I walk in a room. It’s what I do. I am a nurse for 40 years. I look at every single person, and I assess them,” she said.

School board member Joy Beers said she would like to see students have an option to get the Lions’ exam because it has benefits.

“I think there’s a benefit in what the Lions Club offers, and I don’t see why we can’t have the two systems working in tandem,” she said.

Guardiani pointed out that the Lions’ exam requires students to take home and return a permission slip. When the exam is complete, they have to take home the printed results.

“Those permission slips aren’t even going home, much less coming back,” she said.

Bradley said that the Lions’ vision screener has been recognized by the Harvard Business Review for its ability to quickly conduct vision screenings.

The nurses said they would like to see the Lions continue to help provide financial support for students who need glasses and follow-up vision appointments.

“What we do require is assistance in obtaining vision exams and eyeglasses for students who fail the screening but have no insurance or financial resources to do so,” Harleman said.