Sen. Gary Farmer's Newborn Eye Exam Bill Gets Overhaul, Some Proponents Say It's 'Watered Down'

Feb 12, 2020

Sen. Gary Farmer (D-Broward) has overhauled his bill that would have mandated a certain eye exam for newborn babies, now calling for a pamphlet on the exam to be given to expecting parents.
Credit The Florida Channel

A bill that would have mandated newborn babies be given a certain eye exam just got a drastic overhaul by way of a strike-all amendment. Proponents of the original say it’s now watered down, but some are glad to see what they feel is progress.

Before this week, Senator Gary Farmer’s bill would have required medical professionals to give newborns an eye test that can catch things like cataracts – or worse. The test would involve using eye-dilating drops on the baby, then a doctor would look into the eye using an ophthalmoscope to detect abnormalities. But after a strike-all amendment filed by Farmer was adopted, the bill now calls only for a pamphlet with information on the eye exam to be given to parents.

“Senator, it’s the compromises and collaboration that we do here in the Senate,” Farmer told a colleague on the Senate Health Policy panel, asked about the strike-all.

The pamphlet would be written by the Department of Health and distributed by an OBGYN to expecting parents. Farmer says the compromise is still progress.

“I think there were concerns about a mandate, I think you heard in Sen. Bean’s question,” Farmer said. “I think some others had concerns about the parent rejecting, and so we feel this pamphlet will provide the information necessary for parents to make an informed decision.”

J.C. Singh, a pediatrician who practices in Tallahassee, spoke on behalf of the American Association of Pediatric Ophthalmologists – which supports the bill after the strike-all. But as it was originally written, Singh was concerned about the eye drops. She told the Senate health panel why:

“These are typically sympathomimetic drops, and can have very serious side-effects for infants,” Singh said. “Once these drops are put in the baby’s eyes, it is estimated that about 80 percent of these eye drops enter the tear duct of the baby, and then are absorbed into the baby’s blood stream.”

Some of those side effects, according to Singh, can threaten newborns’ cardiovascular, gastrointestinal and central nervous systems. Singh says there is a protocol in place for eye screening in newborns.

“They are examined by a pediatrician or a family practice doctor, or an ophthalmologist usually within the hospital, with an ophthalmoscope,” Singh added.

Democratic Senator Lori Berman sees value in the compromise.

“I am a little sad that we have had to water the bill down so significantly,” Berman said. “But I think that, for us to be here and discussing it, and giving out an electronic pamphlet that will be required, will at least get the word out.”

But as the pediatric group and some lawmakers are placated by the bill’s overhaul, not everyone is as happy to meet in the middle.

Pam Bergsma has been lobbying for newborn eye exam legislation for 20 years, since her grandson died from a deadly cancer of the eye called metastatic retinoblastoma.

“Joey was a normal, healthy, beautiful little boy. And, shortly after his second birthday, he said ‘Grandma, eye, eye’ … and he was screaming with pain.”

Retinoblastoma can metastasize to the brain if not dealt with quickly.

“This is a pediatric cancer,” Bergsma explained. “It’s one of the most common cancers in children and the most common eye tumor in children, affecting approximately one in 12,000.”

But, Bergsma says her advocacy on the issue isn’t only in the interest of preventing retinoblastoma.

“First of all this is not about retinoblastoma. It’s about making sure every child has the best sight possible – and the number 1 thing we’re looking for in those newborn eyes is cataracts,” Bergsma said. “One in every 677 live births is presented with something that is going to take their sight, or worse.”

Bergsma still wants eye exams to be mandatory. Speaking in committee and wearing a pin that says her grandson’s name, she attempted to rebut Pediatrician J.C. Singh’s claims about eye drops, but only had one minute to speak.

Bergsma: “Now that tiny little newborn pupil, it just needs this simple little eye dilation drop. For decades they have done large, national and international studies on these drops. And I know I can’t talk about it, but it’s all right here…”

Senate Heath Policy Chair Gayle Harrell: “Thank you so much.”

Regardless, the amended bill now only allowing for the distribution of a pamphlet is moving forward in the Senate, having passed the health panel unanimously.

A House bill is filed that is identical to Farmer’s original measure, mandating the eye exam. It hasn’t yet gotten a first hearing.