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An Interview with Dr. Edward Cordes on the Importance of Early Detection and Treatment of Vision Problems in Children

We are honored to speak with Dr. Edward Cordes, Chairman of the Lions KidSight USA Foundation, about his role in creating a national vision screening program for kids six months to six years old. All Lions Clubs in the United States and Puerto Rico have the opportunity to participate.

Vision problems are common among children, with 19 million worldwide living with a vision disorder.1 Vision disorders often have no noticeable symptoms,2 and as a result, children may not realize they see the world differently than others.3

Unfortunately, according to the National Survey of Children’s Health (2016-2017), only one in three children in the United States has received eye care services before the age of six.4

Dr. Edward Cordes, Chairman of the Lions KidSight USA Program

Dr. Cordes and his wife Gail have dedicated their lives to ensuring that children at risk for amblyopia and other vision issues are properly diagnosed and receive the professional eye care they need.

This summer, they launched Project SEE CLEARLY 2021, an initiative designed to provide Lions Clubs with the tools to restart their vision screening services as soon as possible. This program has a goal to clear up the national backlog of children who may have missed their vision screening during the COVID-19 pandemic. Their goal is to screen one million children at schools and daycare centers throughout the country by December 31st, 2021.

The following is a transcript of our interview with Dr. Edward Cordes. Some content has been edited for brevity and clarity.

1. Tell us about yourself. Where are you from?

I was born in Queens, New York, and lived there until I was 13. My dad’s business transferred to the Cleveland area in 1963. I finished high school there and then went to Ohio State University for two years.

2. Where did you find an interest in optometry?

I was born with a cleft palate and hare lip, so I had a lot of surgery throughout my early life and always knew I wanted to do something in healthcare. I spent four years in the Navy as a hospital corpsman (medic) and used the opportunity to explore various health professions.

Optometry stood out as I was fascinated with the process of vision and, for the most part, ophthalmic treatments are effective with a lot of positive feedback for the doctor and patient.

3. How did you become involved with Lions Club International?

While I was in the Navy, I served in Vietnam and was involved in the MEDCAP program. We would load medical supplies into a Jeep and, with the guidance of a young civilian translator, travel to small towns an hour or so off base to provide healthcare to the local population. This experience awakened my understanding that the world is not like Middle America in which I grew up.

Consequently, after leaving the Navy and going to Pennsylvania College of Optometry, I volunteered for and chaired an optometric service trip to Haiti. Eighteen students and a faculty advisor traveled to the country to provide eye care to the local population. Lions in the Philadelphia area supported us with funding and used eyeglasses. In recognition of their support and a continued desire to serve, I joined Lions in February 1976.

After graduation, my wife and I started a practice in Corning, NY. We know how fortunate we have been throughout our lives and have a strong sense of obligation to give back a bit of our good fortune (luck) to those not as lucky as we have been.

4. You currently serve as the Chair of the Lions KidSight USA Foundation. Can you tell us about the mission of Lions KidSight USA and what you hope to achieve?

The Foundation’s mission is to unify the various Lions Clubs vision screening programs that were already in existence in 2014 under one branded umbrella. We established national “best practices,” encouraged more Lions to become involved in children’s vision screening and created a “national brand” for the Lions of the USA. We also created a certification process for Lions to demonstrate they understand the underlying principles of vision screening.

Our goal is to have robust, structured screening programs in all 50 states and Puerto Rico. This includes screening all children from age one through grade 12 with a meaningful follow-up system to ensure those detected as having risk factors receive the professional eye care they need.

When we were established in 2014, Lions nationwide were screening about 500,000 children a year. During the 2018-19 fiscal year, just prior to the COVID-19 pandemic, Lions screened approximately 2,000,000 children with about a 12% referral rate.

Dr. Edward Cordes volunteering during a Lions Club screening event

5. Why is vision screening at a young age so important for children?

Young children are at risk for having many eye conditions that do not necessarily present with signs or symptoms. One condition, in particular, is amblyopia or lazy eye. Amblyopia is a condition where one eye doesn’t function as well as the other due to a refractive (eyeglass prescription) condition or an eye turn or other issue. It causes the brain cells responsible for interpreting the image from the affected eye to either not develop or develop incompletely. If this condition is not caught and treated by the age of six, the chances of successful treatment are dramatically reduced. The child will have reduced vision or a legally blind eye for life.

In addition, 80% of learning comes from vision and visual input. If a child is visually impaired, their ability to efficiently learn and reach their full potential in life is also impaired.

6. Do you find that instrument-based vision screening improves efficiency?

Yes. No screening process will ever replace a professional comprehensive eye exam with a dilated pupil. However, electronic, instrument-based photorefractive screening is the most efficient and effective way to identify those children who have risk factors for vision impairment. It is fast, touchless, totally objective and meets the standards of accuracy set forth by all the public health and professional organizations for screening processes.

Instrument-based screening is often compared to chart-based screening in which a child is asked to read letters from a chart designed more than 100 years ago. This old system is totally subjective and not accurate in detecting some conditions such as significant hyperopia (farsightedness) or strabismus (eyes that don’t point together at the same thing at the same time).

7. Can you explain the Lions KidSight USA’s data management process? What is the purpose? What are you hoping to achieve with the data you collect?

Lions KidSight USA’s database is designed to capture aggregate information (without personally identifiable information) on the number of kids screened, the age group of those screened, the number referred and the number of those referred who went for professional care. We will soon be capturing the indications for referral for those referred.

The first goal of the system is to document the great job Lions Clubs are doing in conducting effective children’s screenings. However, since the data is collected regionally, the data will provide accurate epidemiological information on the various vision conditions children have. This, in turn, can lead to better organizational and governmental decisions on allocation of eye care resources.

8. Over the last year, it’s likely many children have missed having their vision screened due to the COVID-19 pandemic. Can you tell us about Project SEE CLEARLY 2021? What are your goals?

The closing of schools and daycare centers resulting from the COVID-19 pandemic has resulted in a backlog of children that have not been screened. That means two million kids were not screened and the 12% of those who would have been referred were not notified that they have risk factors for vision issues. In addition, we now have the new year’s group of children to screen. Project SEE CLEARLY 2021 is designed to motivate Lions Clubs and provide them with the tools to restart their screening services as soon as possible. In addition, we are working to encourage schools and agencies to again invite the Lions Clubs into their programs to perform screenings and educate parents on the importance of following up on referrals for professional eye care.

In recent months, many professional, peer-reviewed articles have detailed the increase in physical and visual issues associated with the large amount of screen time children have endured over the past 18 months. Dry eye, tired eyes and increase in myopia are a few of these. Project SEE CLEARLY 2021 is designed to detect the visual issues that may be causing these problems.

9. What advice would you offer to help others who are new to vision screening and considering an investment in instrument-based vision screening?

Lions KidSight USA Foundation will soon release a startup packet with information for Lions Clubs, parents, teachers and administrators on the need for screening and the risk factors for which we screen. There will be an “Event Planner” that Lions Clubs can use to design and implement an efficient, accurate program.

When Lions Clubs are considering getting involved in this program, they should carefully evaluate their investment in the equipment needed. The devices recommended by Lions KidSight USA Foundation are accurate and easy to use. With proper care, they will last for many years of hard service.

It is important to choose a screening device that truly screens for the risk factors that affect children most. Refractive errors such as myopia, hyperopia and astigmatism are the leading causes of vision impairment in the world. The screener must accurately detect these conditions. In addition, the recommended devices screen for strabismus and unequal pupil size. Any instrument unable to detect these conditions does not meet the “best practices” of Lions KidSight USA Foundation.

Click here to learn more about the Welch Allyn Spot Vision Screener, an instrument-based vision screener approved by the Lions KidSight USA Foundation, that can help you quickly and easily detect amblyopic risk factors in patients from six months of age through adulthood.

Learn More

If the financial investment is too much for one club to afford, two or more clubs can jointly purchase a device and share it. Lions Clubs International Foundation will consider a grant application for district, multiple district or regional development of a large program by providing 50% of the funding to purchase the necessary equipment. To receive approval, these programs must follow Lions KidSight USA Foundation best practices.

Author photo of Kaitlin Lyons

By Kaitlin Lyons, Manager, Marketing, Vision Screening & Diagnostics

References
  1. Children’s Eye Foundation. https://www.childrenseyefoundation.org. Accessed January 2, 2019.
  2. Children’s Eye Foundation. A Practical Guide for Primary Care Physicians: Instrument-Based Vision Screening.
  3. Prevent Blindness Wisconsin. Give Your Child the Best Vision Possible. https://preventblindness.org/wp-content/uploads/2020/08/PB_Best-visionpossible_parent-checklist.pdf. Accessed December 22, 2020.
  4. Prevent Blindness Wisconsin. Our Vision for Children’s Vision: A National Call to Action for the Advancement of Children’s Vision and Eye Health.