University of Arizona researchers recently were awarded an $880,000 grant from the National Eye Institute (NEI) at the National Institutes of Health to continue the Tohono O’odham Vision Screening Program on the Tohono O’odham Nation, west of Tucson. The award is funded under the American Recovery and Reinvestment Act of 2009.
The Tohono O’odham Vision Screening Program is a partnership between the Tohono O'odham Nation and the UA. Now in its 13th year, the program seeks to understand the unique vision-care needs of children of the Nation who display high levels of astigmatism, a condition that requires eyeglasses for clear vision. If uncorrected, astigmatism can lead to amblyopia – sometimes called “lazy eye” – which is poor vision that cannot be treated successfully with corrective lenses.
Since the program began, it has identified optimum ways to screen for children who need glasses, identified the specific types of amblyopia that arise from uncorrected astigmatism and demonstrated that children can respond to treatment much later than previously thought.
Erin M. Harvey, PhD, associate professor at the UA Department of Ophthalmology and Vision Science, is principal investigator for the project. Dr. Harvey explains that the award will be used to examine children in the sixth through 12th grades, who first were seen as Head Start participants, to see how their eyes have changed as they approach adulthood and to better predict the impact of interventions in the early years of life on adult vision of tribal members.
"We are excited to have the opportunity to continue our work with the children and families on the reservation,” Dr. Harvey says. “It is an honor to be welcomed into the community, and I look forward to seeing the children again. We hope that what we learn about astigmatism will benefit the tribe, as well as all children with high astigmatism."
Joseph M. Miller, MD, MPH, is the medical director of the project. Professor and head of the UA Department of Ophthalmology and Vision Science, Dr. Miller began the project in 1997 with NEI funding to test and treat 4- and 5-year-olds on the reservation for astigmatism and to identify the best screening methods to detect the condition. The initial four-year study found that about one in every three Tohono O'odham preschool children required eyeglasses for astigmatism, compared to one in 20 in the general U.S. population. The study tested more than 800 Native American children for astigmatism, and corrective glasses were given to those who had the condition.
Subsequent phases of the study focused on children in kindergarten through sixth grade to determine the maximum age at which children could successfully be treated for amblyopia resulting from uncorrected astigmatism and from 6 months of age through first grade to study early development of astigmatism and amblyopia.
Dr. Miller notes that many Native American peoples share the high prevalence of astigmatism seen in the Tohono O’odham children, as do many Hispanic Americans.
"We hope to learn how the child's eye becomes adult-like and how the eye changes over time,” he says. “It is a rare opportunity and privilege to be able to work with the tribe over so many years and to revisit our first children now as they are to graduate from high school."
An added benefit of the program is that eyeglasses are provided to children who are tested and found to need them. To date, the Tohono O'odham Vision Screening Program has provided more than 6,600 eye examinations and more than 7,000 pairs of eyeglasses at no charge to children living on the Tohono O'odham Reservation.