By Lisette Hilton
Retired RN Loreen Bridges has set her sights on addressing and preventing vision problems in children. Bridges, who retired in 1994 after a 30-year nursing career in nursing administration and social services, has volunteered for nearly 15 years with Prevent Blindness Northern California. Founded in 1966, PBNC offers services and programs in 48 Northern California counties that help break down barriers to vision care and eliminate preventable blindness by detecting vision problems while they’re treatable
Bridges screens preschoolers for eye conditions, trains fellow volunteers, advocates for children and families and even raises funds for the Santa Cruz, Calif., arm of the regional charity. She says she spends from 10 to 12 hours each week volunteering for the nonprofit agency. About 700 children were examined last year.
Bridges and other volunteers examine the children and refer those who don’t pass the eye exams to local optometrists or ophthalmologists for needed care. Referrals tend to be more frequent in the more at-risk population, including children who are from low-income areas and have less access to medical and optical care, according to Bridges. She often follows up with teachers and parents to find out if the children have been taken to get complete eye exams. “I contact the parent in writing and by phone, if necessary,” Bridges said.
Identifying vision problems early is an important mission. It can be life-changing for young children and parents who might not know there’s a problem, Bridges said. “The children that need help might have a behavioral problem, or they might be very quiet and don’t partake in preschool activities,” she said. “Then, when their vision is corrected by patching, surgery or glasses, suddenly, they’re a different child. They blossom in the classroom. That’s what keeps me going.”
The main focus is detecting amblyopia, or lazy eye. “It’s very correctable, but only up to age 6,” Bridges said. “Normally, it’s not found until people are old enough to start complaining about poor vision. The children don’t realize that they can see in one eye and can’t see with the other eye, or they’re seeing with both eyes but have two images.”
The children’s vision exams also may detect infections, cataracts, poor eye tracking or the need for corrective lenses.
One of many success stories
Bridges recalled a preschooler she calls Susie* who, at 4 years old, didn’t participate in classroom activities, including art and writing. Teachers implied she had a behavior issue, but the real issue was that Susie had a vision problem. “In fact, when we attempted to screen her, she made excuses not to be screened,” Bridges said. “Even though she was a cooperative child, I think that her vision problem limited her ability to see and do most things, so she was reluctant to try anything she was not familiar with. I said that I would work with her until she felt comfortable and trusted me; then, I would evaluate whether or not I could screen her.”
It’s not required in California to have parental consent for the screenings. But parents are informed about screenings and can request not to have their children screened, according to Bridges.
Pediatricians often miss recognizing amblyopia since their vision screening procedure is not geared toward recognizing the disorder. But Bridges’ exam suggested Susie had amblyopia, and it was confirmed by an ophthalmologist, who said Susie’s amblyopia was severe and warranted treatment, which included eye patching. “The optic nerve will actually regenerate if [patching] is done early enough,” Bridges said. “The parents patiently cared for her as the vision in her poor eye improved. When her double vision was gone, suddenly she said, ‘OK, now it’s my turn. I need to know how to write my name, too.’”
Education allays fears
It isn’t always easy to screen such young children, according to Bridges. It takes a lot of cajoling because the children don’t understand why they’re being tested or are fearful that they have a vision problem. There are often language barriers, as well. “The first time we went to a school that was predominantly Hispanic, seven children burst out crying,” she said. “They were freaked out. I think they were pleasantly surprised when they found out we were so engaging and caring. Now, the children we saw last year run up to greet us.”
The follow-up with the parents may be the most challenging part of the job, she said, but educating the parents about the necessity of early treatment is important. “You’d be amazed how many parents are reluctant to make an appointment for their child or admit there’s something wrong with their child,” Bridges said. “I spend quite a bit of time calling these schools and parents asking if Johnny got his glasses, if Johnny has seen the doctor. Getting them a doctor’s appointment sometimes is necessary, or even obtaining a voucher for glasses.”
Still, the challenges do not overshadow the joy Bridges gets from this extension of her nursing career. “I went into nursing because I always liked helping people,” Bridges said. “I enjoy helping the children get the care they need while at a young age and giving them a better start for their schooling. I care about those kids.”
Lisette Hilton is a freelance writer. In the photo, Loreen Bridges, RN, a volunteer with Prevent Blindness Northern California, is pictured with preschooler and patient Lola Ramirez. Photo by Carlos Garcia Photography.
*Name has been changed.