Illinois' Eye Exam Law

The story behind Senate Bill 641

Janet Hughes

When Sharon Teefy was given a stack of adopted resolutions to review for possible legislation, one caught her attention—a required vision examination before entering kindergarten.

"I was surprised to learn vision screenings were mandated yet weren’t picking up all the children with vision problems,” said Ms. Teefy, legislative director for the Illinois Federation of Teachers (IFT).  “And for those who failed a vision screening, only 29% had the follow-up eye exam!  This was unacceptable.  Especially since the resolution found vision problems can interfere with learning and contributes to poor school performance.  It was obvious a state requirement for eye examinations was needed.”  


State requirement needed for years

In 1969, the Illinois Department of Public Health began mandating vision screenings for all children in any public, private, and parochial school.  In 1987, Illinois lawmakers recognized vision screenings were limited and should not be the only means of detecting children’s vision problems.  Governor Thompson signed a bill into Illinois law that recommended schools require vision exams with the health exams before entry into kindergarten, fifth, and ninth grade. 

Twenty years later, only a handful of schools adopted a vision policy due to efforts by local optometrists.  Dr. Tim Ortiz from Morris, Illinois, was the first optometrist to persuade his local schools in 2001 to implement a law passed fourteen years earlier.  “I saw enough patients fall through the cracks of inadequate vision screenings.  I’m surprised more schools haven’t recognized the value of vision examinations.”  


Vision screenings missed my child

My hometown school district was one of many that chose to ignore a recommended vision policy.  When we enrolled our eldest daughter in kindergarten in 2001, only the health and dental forms were in the registration packet.  During the school year, she passed the mandated vision screening.  The following year we suspected a problem and brought her to an optometrist.  An eye exam found what vision screenings missed—poor vision.  My advocacy for comprehensive eye and vision examinations began.  Since academic learning is estimated to be 80 percent visual, her vision problem should have been corrected before starting school.   


Screening is not a substitute for exams

During the fall of 2002, my school district agreed to inform parents before a vision screening was given.  They also said they would do no more unless it was mandated by the state.  In 2003, I initiated legislation with my district’s state senator, Christine Radogno.  Six months later, Illinois became the first state with a vision screening disclaimer.  Parents would know a vision screening is not a substitute for a complete eye and vision evaluation by an eye doctor.  Parents would have a choice of an eye exam in place of a vision screening. 

I knew more was needed in raising the standards of eye care—a required vision examination.    


Screenings versus examinations

When I researched children’s vision, I learned optometrists and ophthalmologists held different views in the detection and treatment of children’s vision problems.  The American Optometric Association (AOA) and the American Public Health Association (APHA) supported vision examinations.  On the other side, the American Academy of Ophthalmology (AAO), the American Academy of Pediatrics (AAP), and Prevent Blindness America (PBA) supported vision screenings.  A law requiring an eye exam by an eye doctor was not going to be easy to pass in Illinois. 


PTA adopts resolution for required vision exams

A call-to-action was needed to raise the standards of children’s eye care.  I prepared a resolution, Required Vision Examination Before Entering Kindergarten.  In 2004, Illinois PTA adopted the resolution as written at their annual convention.


Nora Waliczek, Illinois PTA honorary life member and a Vision First board member, tried to change the system during the early 1970’s.  “Vision screenings didn’t catch my son’s vision problem,” said Mrs. Waliczek.  “But an optometrist’s vision exam did.  The screeners and ophthalmologists lobbied against vision exams back then and still do now.  I don’t know why anyone would be against something that is good for the children.  I’m proud the largest group for parents supports required vision exams.”


IOA produces video

In 2004, the Illinois Optometric Association (IOA) was awarded a grant from the National Eye Institute and produced the video, Save a Child’s Vision—Save a Child’s Future.  Educating the legislators and public was needed to pass a required eye exam law. 

Dr. Pamela Lowe, president of the IOA in 2003/04, said: “The video is a wonderful springboard to the idea that eye exams should be required.  As an eye doctor for over 20 years, I’ve seen countless conditions that could have been cured or greatly corrected if they had been caught early.”  Dr. Lowe was the third optometrist to persuade her Catholic school to implement the 1987 vision law.  “When the pastor, principal, and school board saw the video in 2004, it was a no-brainer.  They became aware of its importance and began requiring eye exams at the local level.”


IFT adopts resolution

The largest group of teachers would be approached next.  Mrs. Waliczek, also an IFT member, gave the newly adopted PTA resolution to her local teachers’ union, Local 571.  We hoped the IFT would join the Illinois PTA and that together, legislation could be enacted.  Parents and teachers have great influence. 

Jane Russell, president of West Suburban Teachers Union Local 571, was thrilled with the idea.  “The resolution made sense.  As chair of the Pre K-12 Teachers Committee for 2003-2007, we agreed no child should struggle in school with an undetected vision problem.  We’re proud our union recognized this important health issue and unanimously adopted the resolution.  Our teachers want the best for children.”    


Senate Bill 641 introduced

In February 2007, the IFT initiated legislation requiring all children in any public, private, or parochial school to have a vision exam by an eye doctor before entering kindergarten (or the first grade).  Senator Deanna Demuzio was proud to be the chief sponsor.  "Senate Bill 641 is a good bill.  Illinois requires health and dental exams.  Vision should be required, too.  Good vision is important for learning in school.”  

Representative Jil Tracy was excited to be the chief sponsor in the House.  “I have four children and three of them wear glasses!  Parents want what’s best for their children.  Senate Bill 641 gives every child in Illinois the best educational advantage.  Who wouldn’t want our children to succeed free of vision problems?” 


Senate Bill 641 moves quickly

The bill moved quickly through the Senate without opposition until it reached the House.  The bill mandated an eye exam with a health exam.  If a parent did not comply by the October 15th date, their child would be excluded from school.    

The Illinois Association of Schools Boards (IASB) was one of the groups against this idea.  Ben Schwarm, executive director for the IASB, said:  “We opposed the initial draft but were able to develop language we could all agree upon.” 

The bill was amended in the House.  It modeled Illinois’ dental law now.  School boards could withhold a child’s report card if a parent did not comply.  A child would not be excluded from school.  “I’m glad we were able to work this out,” said Mr. Schwarm.  “The new law falls in line with a belief statement IASB adopted regarding vision examinations as part of a student’s overall health and wellbeing.”

Four months later, a bill with unanimous support was sent to the governor’s desk.  All House and Senate members wanted the best for Illinois’ children.


The governor’s surprise veto

Sixty days later, Governor Blagojevich placed an amendatory veto on Senate Bill 641.  We were stunned.  He sent it back to the Senate with changes.  Three key parts were removed:  glaucoma evaluation; refraction to best visual acuity at near and far; and that an eye doctor shall complete the exam. 

Michael Horstman, executive director for the IOA, said:  “The governor turned an eye exam into a glorified vision screening.  An eye exam without a refraction is not an eye exam.  Since medical doctors do not have the equipment or training in eye care, the change would allow a doctor to do a screening yet charge it as an exam.”  This was wrong.


Senator Demuzio files again

On October 2, 2007, Senator Demuzio filed a motion to override the governor’s veto.  Our hope returned.  The chief sponsors didn’t want to lose a good law that would help children.  Hours later, it passed with only two senators siding with the governor.  Representative Tracy filed her motion on October 5, 2007.  The following week, the House unanimously approved the override.  Senate Bill 641 became law.  The children of Illinois won. 


The kindergarten packet now

Mrs. Waliczek’s son started school in 1973 without an eye exam.  My daughter started school in 2001 without an eye exam.  The system failed our children and countless others.  We didn’t know.  Then we learned.  We took action.  We raised the standards.  Effective January 1, 2008, all children in Illinois will have an eye exam before starting school. 

Senate Bill 641 is a great example of a team effort.  Together, with the IFT, Illinois PTA, IOA, IASB, and the 95th Illinois General Assembly, we did what we couldn’t do alone.  We are bringing children’s eye care into the 21st century.  We are making a difference in the eyes of a child.


Janet Hughes, founder and president of Vision First Foundation, is a former full-time teacher and currently a stay-at-home mother of five children.  She can be reached here...

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