As a pediatric eye doctor and associate professor at the University of Minnesota, I was disappointed with a Sept. 21 article about legislative consideration of a mandate for comprehensive eye exams for children ("A close look at kids' eye exams.") Since the article was published, I have heard similar disappointment from other physicians and from nurses.

The article suggested that it is odd for Minnesota ophthalmologists to have voiced concern about a mandate. What is odd to me and many is that such an article would be published without a broader understanding of health care. Optometrists and ophthalmologists both applaud the fact that the Affordable Care Act pays for a child with conditions warranting an annual eye exam to get one. The same hopefully holds true for those needing dermatology, orthopedic or even cardiac exams annually. But health care payment reform has not dictated when such exams are needed. It has not suggested that healthy, symptom-free children need formal eye examinations at all.

At face value, most individuals see a single, mandatory eye exam in children as a good thing. Yet many organizations in health care and public health are unified in the belief that the best investment to catch kids with eye problems is through building up evidence-based screening programs.

It is true that in Minnesota, ophthalmologists prefer investment in proven vision-screening programs that extend from a child's birth, through every pediatric visit, through school and beyond instead of a set exam for certain conditions at a given age. A comprehensive exam has simply never been shown to be better than a longitudinal series of screening exams. Despite lack or paucity of evidence to justify the greater expense, four states have decided to try mandatory eye exams. Yet I know of 14 others that have looked carefully at the high value of screening and have realized that the best investment of taxpayer dollars is in bolstering such efforts. Many have modeled their programs after the one we have in Minnesota.

The article tried to paint this as some sort of turf war between Minnesota eye care providers. Again, the issue goes far beyond our own eye doctors and touches the hearts of many who care for our kids across the country. Vision screening programs have been equipped, proven effective and defended by the American Academy of Pediatrics, the National Association of School Nurses, the American Academy of Ophthalmology, the American Association of Certified Orthoptists, the American Association for Pediatric Ophthalmology and Strabismus, and the Children's Eye Foundation, to name a few. In addition, various groups for teachers, state health departments and public health programs have looked at the data and support screening. Plus, I can't say enough about the steadfast support by Lions International in states that don't have their own programs.

Would I enjoy further state investment in detecting and treating pediatric eye disease? You bet. But I am not interested in spending massive amounts of taxpayer or federal dollars to examine healthy, well-functioning children who have passed vision screening year after year. Children who don't fit that description are already triaged into the eye health care system. And the data show that we do a good job of that. What makes me excited is the research showing that, with investment, we are doing vision screening better than ever. We have affordable, handheld technologies in pediatricians' offices and schools today that detect vision problems and eye disease in seconds. In some cases, I think, these technologies do a better job than an eye exam.

And consider the time saved for those who would otherwise have to take time off work, and take children out of school, for a mandatory exam. Consider the benefit to children with vision symptoms and real problems if the healthy ones don't have to bog down the doctor's office.

Vision screening in Minnesota is worth celebrating and fostering, not replacing at higher expense. Ophthalmologists know it; research proves it, and I hope the Star Tribune and our legislators can champion it.

Dr. Erick D. Bothun is an associate professor in the departments of ophthalmology and visual neurosciences and pediatrics at the University of Minnesota.