Dr. Natario Couser
Just 60 seconds after entering the office of Dr. Natario Couser at Virginia Pediatric Ophthalmology Specialists and you already know he’s not only an expert physician, but he’s a very down-to-earth person and easy to talk with. Our conversation quickly turned to the adorable photo of his 3 1/2 month old son. With his wife currently completing her residency, they are a busy couple.
After spending some time with Dr. Couser, we learned that his sincere concern and caring for children extends beyond his personal life, and into his medical practice.
Dr. Couser is a Pediatric Ophthalmologist and he is the newly appointed Medical Director of the WHEELS Program. A pediatric ophthalmologist is a medical doctor who was first trained in diseases and surgery of the eye after finishing medical school. They then pursue further training in the diagnosis, treatment and surgery of those eye disorders that are unique to children. This makes Dr. Couser highly qualified to treat vision issues in children and to serve as Medical Director of the free WHEELS Program.
WHEELS: A Free Screening Program
The WHEELS program (Where Healthy Eyes and Ears Lead to Success) is jointly developed through Prevent Blindness Mid-Atlantic and the MEDARVA Foundation. It is a pre-school vision and hearing screening program, designed to promote healthy vision and hearing as a component of school readiness.
According to Dr. Couser, “An estimated 80 percent of what a child learns in a normal classroom setting is through vision and 75 percent of a child’s normal school day includes an auditory component. Considering these statistics, it’s easy to see how healthy vision and hearing contribute to a child’s overall success in school. I am proud to be a part of this innovative program, unlike any in the country.”
Since there is no federal guideline or mandate to make sure hearing/vision testing is consistent across the states, it’s up to individual states to create their own. With 50 different states, that means 50 different things going on related to testing children’s vital functions of seeing and hearing. Unfortunately, lots of kids unknowingly enter school with some type of vision problem that affects their educational and social interactions.
We asked Dr.Couser what parents need to know about testing, and he gave us some great information.
Potential Vision/Hearing Problems
“Many conditions in kids are asymptomatic and parents or children don’t even realize there is a problem. Some of the potential issues affecting kids can be effectively treated at a young age, but are more difficult to treat once children are older,” he explained. “Amblyopia is an example of a condition that can potentially cause permanent vison loss if not treated early. Of children who are diagnosed and treated before age 7, over 75% usually recover completely normal vision. Delaying treatment can result in permanent vision problems and after age 7, a higher percentage of patients will unfortunately not reach their full vision potential.”
In Virginia, it’s recommended that children receive a thorough hearing and vision test in kindergarten, 3rd, 7th and 10th grades. These are good baselines, but availability of screening by the school nurse or other staff does not guarantee that every child is tested or problems are detected with standard screening processes.
And vision testing really begins at birth and with each pediatric well-baby checkup thereafter. Even infants can follow lights and sounds as a part of the testing process. Dr. Couser explains that referrals from pediatricians make up a big part of his patient list.
“Pediatricians are great for front-line testing. They can refer to specialists if a potential problem is detected and this allows more thorough testing,” Dr. Couser says. “There is a difference in a vision screening versus a comprehensive exam so having that preliminary screening is efficient in finding issues.”
How WHEELS Works
“We are fortunate to have the WHEELS Program in Richmond. It is very unique and I’m not aware of any other screening program prior to kindergarten like this in the U.S. We have a model program here. And it’s an easy and free program for schools to offer.” The program has screened close to 7,000 kids so far and they are partnering with 70 school-related programs in the Richmond and surrounding area.
Dr. Couser explains how the program works:
- The WHEELS Program is scheduled at local schools or pre-schools.
- Screenings are conducted in collaboration with the school health nurse or day care coordinator, and delivered by a certified screener. The screenings are performed using the plusoptiX screening technology vision screener and the Welch Allyn OAE hearing screener, both highly advanced technological screening devices, meaning that the child does not have to physically respond to any commands, providing the most reliable results during the screening process.
- During the vision screening, which takes about 15 seconds, a digital camera like device is pointed at the child’s eyes and takes a series of pictures which are then analyzed by the screening software and a pass/refer is generated based on pre-determined parameters. During the hearing screening, which also takes about 15 seconds, a sterile-tipped sensor is placed just inside the opening of the ear, sending a series of frequency-controlled tones down the auditory passage, the tones are recorded and a pass/refer is generated again based on pre-determined parameters.
- The screening takes only a matter of seconds and it takes multiple digital pictures of the eyes and interprets the pictures and measurements to return a screening result.
- The screening program is free to the school and the parents.
- The screening identifies children who potentially have vision problems, some that could potentially cause permanent vision loss.
- Parents of children with potential problems receive confidential information that recommends seeing an eye specialist and includes the findings of the testing. Parents are free to choose any eye specialist for follow-up.
WHEELS assistance is available for scheduling in the cities of Richmond, Colonial Heights, Hopewell and Petersburg; and the counties of Chesterfield, Hanover, Henrico, Goochland, Powhatan, New Kent, Charles City, Lancaster, Northumberland, Richmond, Westmoreland, Amelia, Nottoway and Cumberland.
Dr. Couser emphasizes, “Thanks to a grant from MEDARVA Health Care Virginia, there is absolutely no charge to schools, kids and families for this screening. It’s a non-invasive, quick screening that could save the sight or hearing of a child. Staff are expertly trained and undergo background checks for safety and security. It’s an excellent program available to our community.”
Learn more about Dr. Couser and the WHEELS Program in this video or at MEDARVA.com.
Signs to watch for in children that MAY indicate a need for vision testing:
Squinting
Sitting closer to the TV
Headaches
Drop in grades
Head tilt
Red or irritated eyes
Drooping lid
Eyes shaking
Family history
Genetic abnormality
Eyes crossing after 3 months of age
