Ms. Peabody, School Nurse

Dear Parents /Guardians of these GREAT Triangle Tigers!

There are a few things I need you to consider for the next few weeks of school:

With this change of seasons, if your child has allergies, please be sure they take their medicines as directed. When they feel lousy, can't breathe and have runny, itchy eyes they will not be able to do their best work. There are just 6 more weeks of school, many tests and learning still to do. Please do your best to help them be successful! Ask your Family doctor about seasonal allergy medicine.

If your child has a fever of 100.0F or more THEY WILL BE SENT HOME FROM SCHOOL. Please check them in the morning before they leave. IF they have a fever, please keep them home.

 


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For those of you with 4th or 5th graders:
The series of immunizations for Hepatitis-B is REQUIRED for 6th grade. If you have not completed the series, please do so as soon as you can. The 5th graders who are not compliant, who have not had all 3 immunizations, will have their name sent to the Middle Schools and they will NOT be allowed to start school in the fall. If I do not have the documentation by June the 14th, their name will be sent to the Middle School. The regulation on this immunization is very clear.
The most recent immunization booster, the Tdap, is REQUIRED for 6th grade. If your child has not had this immunization by June the 14th, their name will be sent to the Middle School and they will not be allowed to start school in the fall.
IF YOU ARE NOT SURE IF YOUR CHILD NEEDS EITHER OF THE IMMUNIZTIONS STATED ABOVE, PLEASE CALL ME AT SCHOOL AND I WILL LOOK UP THEIR IMMUNIZTION RECORD.

4.) May is "Cover the Uninsured" month. If you DO NOT have health insurance for your child/children, please call me for more information.

If you have questions about your child or their health, please call me anytime at school. I'll be happy to assist you in any way I can.

Thanks for taking such good care of you children...I will, too!
Dany Peabody, RN, BSN

 

Forms to Download and Print

Health Information Form

Prescribed Medication Authorization Form

Seizure Plan of Care

Diabetic Health Treatment Plan

Parent Pick-Up Letter

Over the Counter Medications

Flu Toolkit

Links of Interest

Center for Disease Control and Prevention
Asthma and Allergy Foundation of America
American Academy of Pediatrics
The Center for Health and Health Care in Schools
School Health
National Program for Playground Safety
Kids Health (includes Kids site and Teen site)
 
 
 
 
 

Summer Safety Tips


   

Tips for Good Health by Seasons

 

 

 
   

January

   

 

 

February

   
   

March

   
   

April

   
   

May

   
   

June

   
   

July

   
   

August

   
   

September

   
   

October

   
   

November

   
   

December

   
 

 

 

   
         

 

 

 

 

 

 

January - Tackling the Flu Season

February - National Dental Care Month

 
  • The flu season is upon us and I would like to encourage you to follow these methods to help prevent cold and flu symptoms.
    Get enough rest, exercise regularly and maintain proper eating habits.

  • Wash your hands frequently during the cold and flu season particularly if a friend, co-worker, or family member is ill.

  • Wash you hands before meals.

  • Cover your mouth when coughing and sneezing and throw away used facial tissues immediately.

  • Avoid warm crowded places at the height of flu outbreaks.

  • Don't allow your child(ren) to play with friends who are sick and do not send your ill youngster to school.

  • Your child must have a normal temperature for at least 24 hours before returning to school.
  • With good health habits, we will all avoid becoming ill this season .Hoping with this information we can all "Tackle" the flu this season.

Click here to watch a movie on the importance of Dental Health

 

 

General Overview The annual observance of children's dental health began as a one-day event in Cleveland, Ohio on February 3, 1941. During that year, February 3-7 was designated as Children's Dental Health Week in Akron, Ohio. The American Dental Association held the first national observance of Children's Dental Health Day on February 8, 1949. This single day observance became a week-long event in 1955. In 1981, the program was extended to a month-long celebration known today as National Children's Dental Health Month. Since 1941, the observance has grown from a two-city event into a nationwide program. NCDHM messages reach millions of people in communities across the country and at numerous armed service bases abroad. Local observances often include poster, coloring, and essay contests, health fairs, free dental screenings, museum exhibits, classroom presentations and dental office tours.

 


 
     

March

April

 

Bicycle Safety


The following information regarding sport and bicycle was referenced directly from the Boston Globe Website:

Bicycle Safety Recommendations:

  • Please wear your bicycle helmet. At least 75% of most serious bicycle injuries are caused by an injury to the head.
  • Always follow the “rules of the road”. Bicycles are subject to the some of the same traffic regulations as motor vehicles.
  • Riding more than one is dangerous and discouraged.
  • Consider attaching a bicycle flag to your bicycle which will increase your visibility from a distance.
  • A safety checklist should be completed prior to riding. Bicycle reflectors and proper bicycle lighting are a necessity for unavoidable night riding.
  • Avoid riding during peak rush hours and on busy roadways which may increase your risk of a bicycle accident. Most bicycle accidents occur between the hours of 4:00 P.M. and 7:00 P.M.
  • Please practice courtesy while riding and enjoy.


Sports Safety Tips

Tips Before Playing

  • The focus in sports is playing the game, but there are aspects that you should evaluate and prepare for in advance. Both parents and kids should be involved in this process. Taking care of the details outlined below before the season or game will add to enjoyment of the sport and help prevent injuries.
  • Questions for Parents to Ask
  • Are facilities regularly checked for safety?
  • Will a first aid kit, ice, and someone certified in first aid/CPR be at all games and practices?
  • Are fluids available?
  • Is safety equipment available or required? If so, does it meet national standards? Is it in good condition?
  • Is there an emergency plan in case of injury?
  • Tips for Parents and Kids
  • Be in shape before you show up for the first day of practice or tryouts.
  • Begin training slowly.
  • Increase your training gradually, without overexerting yourself. If you measure your training in distance, weight or time, increase your training by no more than 10 percent a week.
  • Choose safety equipment that fits your body and meets national safety standards.
  • Do warm-up and cool-down stretches before and after practice each day if they are not included in your athletic program.
  • Drink plenty of fluids before, during, and after participation.
  • Eat properly. Good nutrition helps fuel your body and prevent injuries.
  • Get plenty of sleep. Most injuries occur when you are tired.
  • Take at least one day off a week to let your body recover.
  • Keep things in perspective.
  • Remember the most important thing: have fun. Play with safety!

Click here for more sports safety tips!

 
     

May

June

 

Why Is Handwashing Important?

  • You carry millions of microbes on your hands. Most are harmless, but you can pick up some that cause illnesses, such as colds, flu, and diarrhea.
  • When we forget to wash our hands, or don't wash them properly, we can spread these germs to other people, or give them to ourselves by touching our eyes, mouths, noses or cuts on our bodies.
  • We can also pick up germs from objects, such as doorknobs and stair railings, touched by other people who aren't good handwashers. Think about all the things you touch each day and how many people may have touched them before you.
  • You can learn more about what happens when people don't wash well or often enough by reading the Press Release on WashUp.org (scroll down the page to the section labeled Handwashing Fact Sheet near the bottom). Or check out this video on handwashing made by students at River Ridge High School in New Port Richey, Fla.
  • You can choose the 2.2M high bandwidth version or, if you're using a modem, the 513K low bandwidth version might be a lot faster for you. You'll need the Quicktime player to view these video files. You can download it for free here.
  • Handwashing with warm water and soap can greatly reduce the chances of spreading or getting germs. The mechanical action of scrubbing loosens up the dirt and microbes on our hands and the soap picks them up and binds to them so that the water can wash them away.
  • Handwashing with warm water and soap can greatly reduce the chances of spreading or getting germs. The mechanical action of scrubbing loosens up the dirt and microbes on our hands and the soap picks them up and binds to them so that the water can wash them away.

 

When You Should Wash

  • Before you:
    Prepare or eat food
    Treat a cut or wound
    Tend to someone who's sick
    Put in or take out contact lenses
    Do any kind of activity that involves putting your fingers in or near your mouth, eyes, etc.
    After you:
    Go to the bathroom
    Handle uncooked foods, especially raw meat
    Eat
    Blow your nose, cough or sneeze
    Handle garbage
    Tend to someone who's sick
    Change a diaper
    Play with or touch a pet, especially reptiles and exotic animals

Fun in the Sun

  • Babies under 6 months:
    Avoiding sun exposure and dressing infants in lightweight long pants and long-sleeved shirts and brimmed hats are still the top recommendations from the AAP to prevent sunburn. However when adequate clothing and shade are not available, parents can apply a minimal amount of sunscreen to small areas, such as the infant's face and the back of the hands.
  • Young Children:
    Apply sunscreen at least 30 minutes before going outside, and use sunscreen even on cloudy days. The SPF should be at least 15.
    Older Children:
    The first, and best, line of defense against the sun is covering up. Wear a hat with a three-inch brim or a bill facing forward, sunglasses (look for sunglasses that block 99-100% of ultraviolet rays), and cotton clothing with a tight weave.

  • Stay in the shade whenever possible, and avoid sun exposure during the peak intensity hours - between 10 a.m. and 4 p.m.

  • Use a sunscreen with an SPF (sun protection factor) of 15 or greater. Be sure to apply enough sunscreen - about one ounce per sitting for a young adult.

  • Reapply sunscreen every two hours, or after swimming or sweating.

HEAT STRESS IN EXERCISING CHILDREN
Source: http://www.aap.org/policy/re9845.html

  • The intensity of activities that last 15 minutes or more should be reduced whenever high heat and humidity reach critical levels. (See policy statement for details)
  • At the beginning of a strenuous exercise program or after traveling to a warmer climate, the intensity and duration of exercise should be limited initially and then gradually increased during a period of 10 to 14 days to accomplish acclimatization to the heat.
  • Before prolonged physical activity, the child should be well-hydrated. During the activity, periodic drinking should be enforced, eg., each 20 minutes, 5 oz of cold tap water or a flavored sports drink for a child weighing 88 lbs, and 9 oz for an adolescent weighing 132 lbs, even if the child does not feel thirsty.
  • Clothing should be light-colored and lightweight and limited to one layer of absorbent material to facilitate evaporation of sweat. Sweat-saturated garments should be replaced by dry garments.

BOAT SAFETY
Source: http://www.aap.org/family/tippslip.htm


  • Your children should wear life jackets at all times when on boats or near bodies of water.
  • Make sure the life jacket is the right size for your child. The jacket should not be loose. It should always be worn as instructed with all straps belted.
  • Blow-up water wings, toys, rafts, and air mattresses should never be used as life jackets or life preservers.
  • Adults should wear life jackets for their own protection and to set a good example.

 

BUG SAFETY

  • Don't use scented soaps, perfumes or hair sprays on your child.
  • Avoid areas where insects nest or congregate, such as stagnant pools of water, uncovered foods and gardens where flowers are in bloom.
  • Avoid dressing your child in clothing with bright colors or flowery prints.
  • To remove a visible stinger from skin, gently scrape it off horizontally with a credit card or your fingernail.
  • Insect repellents containing DEET are the most effective.
  • The concentration of DEET in products may range from less than 10 percent to over 30 percent. The benefits of DEET reach a peak at a concentration of 30 percent, the maximum concentration currently recommended for infants and children. DEET should not be used on children under 2 months of age.
  • The concentration of DEET varies significantly from product to product, so read the label of any product you purchase.
 
     

July

August

 

PLAYGROUND SAFETY
Source: http://www.aap.org/advocacy/archives/maytra.htm
Source: http://www.aap.org/family/playgrd.htm

  • Carefully maintain all equipment.

  • Swings should be made of soft materials such as rubber, plastic or canvas.

  • Make sure children cannot reach any moving parts that might pinch or trap any body part.

  • Make sure metal slides are cool to prevent children's legs from getting burned.

  • Parents should never purchase a home trampoline or allow children to use home trampolines.

SKATEBOARD AND SCOOTER SAFETY
Source: http://www.aap.org/advocacy/archives/marskate.htm

  • Children should never ride skateboards or scooters in or near traffic.
  • All skateboarders and scooter-riders should wear a helmet and other protective gear.
  • Communities should continue to develop skateboard parks, which are more likely to be monitored for safety than ramps and jumps constructed by children at home.


LAWN MOWER SAFETY
Source: http://www.aap.org/family/tipplawn.htm

  • Try to use a mower with a control that stops the mower from moving forward if the handle is let go.
  • Children younger than 16 years should not be allowed to use ride-on mowers. Children younger than 12 years should not use walk-behind mowers.
  • Make sure that sturdy shoes (not sandals or sneakers) are worn while mowing.
  • Prevent injuries from flying objects, such as stones or toys, by picking up objects from the lawn before mowing begins. Have anyone who uses a mower wear hearing and eye protection.
  • Do not pull the mower backward or mow in reverse unless absolutely necessary, and carefully look for children behind you when you mow in reverse.
  • Always turn off the mower and wait for the blades to stop completely before removing the grass catcher, unclogging the discharge chute, or crossing gravel paths, roads, or other areas.
  • Do not allow children to ride as passengers on ride-on mowers.
 
     

September

October

 

 

Welcome Back to School!!

The beginning of a new school year brings all the excitement of back to school shopping. When purchasing all the school supplies that your child will need for the upcoming year, please keep in mind one important purchase that often becomes a fashion statement rather than function:

Backpacks

  • Doctors have been sounding the alarm for a while now about how book-laden packs can cause back problems in kids. When choosing the right backpack the American Academy of Pediatrics recommends to look for the following:
  • Wide, padded, shoulder straps: Narrow straps can dig into shoulders. This can cause pain and restricts circulation.
  • Two shoulder straps: Backpacks with one shoulder strap that runs across the body cannot distribute weight properly
  • Padded back: A padded back protects against sharp edges on objects inside the pack and increases comfort.
  • Waist strap: A waist strap can distribute the weight of a heavy load more evenly.
    Backpack itself should not add much weight to the load
  • To prevent injury when using a backpack, the American Academy of Pediatrics recommends doing the following:
  • Always use both shoulder straps. Slinging a backpack over one shoulder can strain muscles. Wearing a backpack on one shoulder may increase curvature of the spine.
    Tighten the straps so that the pack is close to the body. The straps should hold the pack two inches above the waist.
  • Pack light. The backpack should never weigh more that 10 to 20 percent of the student's total body weight.
  • Organize the backpack to use all of its compartments. Pack heavier items closest to the center of the back. Empty unnecessary articles.
  • Additional Resources:
    The back to school tips section of this web site offers tips on selecting and wearing backpacks. Great Schools.Net
  • "A Pain in the Back:
    Backpacks Create Health Problems For Kids."

HALLOWEEN SAFETY

With the weather changing and the leaves falling comes one of my favorite holidays: Halloween. To ensure that your holiday is filled with fun and laughter, please keep in mind these safety rules when allowing your child to trick-or-treat:


  • Make sure costumes fit properly: ensure that hems of costumes are not dragging and masks fit properly.

  • Advise your children to take extra precautions with costume accessories. Avoid swinging wands or other items that may injure an eye.

  • Inspect small children's costumes for accessories that are easily dislodged and may become a potential choking hazard.

  • Trick-or Treaters and their escorts should have flashlights.

  • Instruct your child not to cross lawns where they might trip on tree roots or hoses.

  • Wear clothing that is easy to see in the dark or wear reflective tape on your costume.

  • Advise your older children to stay together.

  • Walk on the left side of the road facing the traffic if there are no sidewalks and watch for traffic.

  • Trick-or-Treaters and their escorts should take note of jack'-o-lanterns and other outside decorations that are lit with candles. Flowing costumes could easily ignite.

  • Costumes and costume parts, wigs, capes, etc., should be made from flame-resistant material.

  • Educate your child that pets may act differently toward costumed visitors and may be overly excited with all the people coming and going. Trick-or-Treaters should not approach any pets.

  • Tell your child not to eat any treats unless you have inspected it first. Any unsealed package should be discarded. If you suspect your child has ingested a tampered food item, you should seek medical attention immediately.
  • Instruct your child to trick-or-treat at homes you are familiar with.
 
     
     

November

December

 

Food Safety Reminders:

  • Buy from trusted sources.
  • Choose fresh or frozen chicken and turkey products that are clean, cold, well-wrapped, sealed tight without rips or leaks, and sold from a refrigerated or freezer poultry case.
  • Refrigerate or freeze poultry quickly after purchase, if possible within half an hour.
  • Defrost chicken or turkey in the refrigerator, not on the counter, allowing a few hours to a full day depending on size.
  • Do not allow raw poultry or its juices to touch other foods.
  • Cook chicken and turkey thoroughly, using a meat thermometer to gauge doneness.
  • Safe Temperatures:
  • 180 F. = dark meat cooked through
    170 F. = white meat cooked through
    165 F. = ground chicken & turkey cooked through
    140-165 F. = foods held warm to serve
  • Keep hot foods hot and cold foods cold. Keep hot foods at 140 F. or hotter; keep cold foods at 40 F. or colder.
  • Wash cutting boards, tools, the sink, all work surfaces and hands in hot soapy water before and after handling raw poultry.
  • Serve cooked poultry using a clean platter and utensils, never ones touched by raw meat.

Holiday Candle and Tree Fire Safety

  • Choose a fresh tree.
    You can test the freshness of a cut tree by bouncing the trunk on the ground two or three times. Only a very few needles should fall. The branches should bend easily and not break.
  • Cut two inches from the tree's base.
    This will open up the pores which have been clogged by sap and make the tree more able to absorb water.
  • Use a stand that holds plenty of water.
    Put the tree in water as soon as possible. Water the tree daily. Don't let the stand go dry. Once the water dries up, the tree trunk will seal over and it cannot draw more water.
  • Place you tree well away from any wood stove, fireplace, heater or heat register.
    Constant radiant heat will dry out a tree quickly and make it very hazardous. Use only cool burning or miniature type tree lights to reduce drying.
  • Make sure your tree is not blocking an exit.
    It should not be placed in front of a door or in a hallway.
  • Put the tree close to an outlet so you will not need to use extension cords.
    If you have more than one string of lights, use only heavy-duty extension cords.
  • Use only lights in perfect condition and that have a tag showing that they are approved by Underwriters Laboratories for safety.
  • With the lights unplugged, check all lights and cords for broken sockets or bare wires.
    Lay the lights on a fireproof surface and leave them switched on for 15 minutes. Check for signs of overheating such as smoking or melting. Don't take a chance! Throw away any strings of lights that show signs of wear or overheating. Even the smallest spark from a frayed light cord can ignite a dry tree.
  • Never use electric lights on a metal tree.
    There is a danger of electrical shock! If you do buy an artificial tree, be sure it is labeled as fire-resistant. Look for the UL fire safety label.
  • Always unplug the lights before going to bed or leaving the house.
    Your tree will dry out faster if you leave the lights on for long periods of time.
  • Never burn a candle on or near a Christmas tree.
    Keep all candles, matches and lighters away from small children. Many Christmas tree fires have started by children playing with matches or candles near the tree. Also be sure that all presents under the tree are kept away from lights.
  • When needles get brittle and dull or begin to fall, this is a sign that the tree is beginning to dry out and should be removed.
  • After you have taken your tree down, never burn your tree in a fireplace or wood stove.
    A dry tree can explode into flames, causing a chimney fire or igniting other objects in the room.
  • Never hang stockings near a fire-place that will be used.
  • All decorations should be flame-resistant.
  • Candles need sturdy nonflammable holders. Place them where they will not be easily knocked over.
  • Candles should be put out before leaving the room or the house, or going to bed.
 
     
     
     
     
     
     
     
     
     
     

More Safety Tips

 

Wear the Gear


  • Safety equipment may reduce injuries, but protective gear is often not worn due to lack of awareness, inappropriate or unavailable equipment, or lack of money to buy the equipment. As parents, coaches and players, we can become better informed and prepared to have our children participate safely in sports activities.The following list includes gear recommended for youth sports. Use safety equipment at all times, including practices.
    Helmets prevent or reduce the severity of brain and head injuries. They have been either mandated or recommended for the following activities: auto and motor sports, equestrian sports, in-line skating, snowmobiling, baseball, football, rugby, softball, bicycling, hockey, skateboarding, wrestling, boxing, lacrosse, skiing. Check the inside of the helmet before you buy it to make sure it is certified by one of the following: National Operating Committee on Standards for Athletic Equipment (NOCSAE), American Society for Testing and Materials (ASTM), Snell Memorial Foundation (SNELL), and American National Standards Institute (ANSI). And beginning in February 1999, all bicycle helmets will be required to meet U.S. Consumer Product Safety Commission (CPSC) safety standards.

  • Hockey face protectors prevent tens of thousands of injuries annually.

  • Wrist guards, knee and elbow pads are prudent for in-line skating and skateboarding. Wearing protective gear for in-line skating is as important as learning the basic skills, such as stopping properly before venturing near traffic or crowded walkways. Kneepads also provide necessary protection for wrestling and hockey and provide shock absorption for volleyball and basketball, especially for female players who are more susceptible to knee injuries.

  • Shinpads should be worn by soccer players.

  • Softer baseballs reduce the risk of ball impact injury, particularly to the head.

  • Safety bases reduce the risk of injury due to sliding. Several types exist, each of which has its own injury prevention mechanism.

  • Face guards for batting helmets are intended to protect the batter's face from being hit by the ball. There were an estimated 59,400 emergency room-treated facial injuries to children ages 5-14 associated with baseball in 1995.

  • Chest protectors for batters may protect the heart (and in some designs, the chest wall and other internal organs) from ball impact injury. Ball impact to the chest was the most frequently reported cause of baseball-related death in children.
    Mouth guards protect the mouth, teeth, cheeks and tongue and cushion blows that cause concussions or jaw fractures. Three different types exist: stock mouth guard, mouth formed (boil and bite) and a custom mouth guard made by a dentist. The three differ in cost, fit and comfort. The stock mouth guard gives the least amount of protection. Mouth guards are recommended by the American Academy of Pediatrics for all contact and collision sports.

  • While you can't wear these for protection, you should know that moveable soccer goals can hurt or kill. At least 18 children died and 60 children were injured by moveable soccer goals during the past 15 years. Many are unstable and are either unanchored or not anchored properly. These moveable goals pose an unnecessary risk of tipping over to children who climb on goals or nets or hang from the crossbar.

On the Field

  • Many factors contribute to players' safety once they begin playing, including good sportsmanship, safety equipment, adult supervision, and a plan for first-aid treatment.
  • Here are tips for safe playing for games and practices:
    Follow the rules. They were set to promote safety. Fill out emergency information cards on each player and have them on hand. Ensure there is an immediate "first responder" certified in first aid and CPR and that a first aid kit is on hand. Determine if an emergency plan has been developed and is on hand. Make sure that players are fairly matched according to size and ability, not age. Ask if practices will be suspended in poor weather.
  • For parents, teachers and coaches: Tell athletes to stop playing if they're in pain - a real indication something is wrong. They should not attempt to "play" through it. Ensure players are evaluated for injuries and informed decisions are made whether they should return, sit out, have immediate medical attention, or be referred for medical attention. And don't have children play if they're overtired - many injuries occur when youngsters are tired.

Sports Injuries

  • Sports injuries fall into two main categories.
  • Chronic repetitive or overuse injuries, such as stress fractures, muscle tears or progressive bone deformities.
  • Acute injuries, occurring as a result of trauma from a major force, such as fractures, dislocations, and more serious injuries like traumatic brain and spinal injuries.
  • Of all the traumatic brain injuries to children in the U.S., 21 percent result from sports and recreational activities. Although children can suffer injuries in any sport, some have a higher injury rate than others.
  • Each year, more than one-half million children 5-14 experience sports-related injuries during participation in the following six sports: basketball, football, baseball, softball, soccer, and gymnastics. So if your child is playing one of these "high-injury incidence" sports, you need to be extra careful and attentive to safety measures.
  • Age and Gender Sports injuries are three times more common for boys than for girls. Prior to puberty, the risk of sports-related injury between boys and girls is the same. At puberty, boys gain in both strength and size and are injured more often and more seriously than girls. The seriousness of injuries for both sexes increases with age and level of competition. A less-developed child competing against a mature child is at a greater risk for injury. Children should be matched and grouped according to similar skill level, weight and physical maturity, especially for contact sports.

Eye Protection

  • Injuries to eyes are common. Blunt objects - paint balls, hockey sticks, ski poles - can fit inside the eye socket and cause devastating injuries. Objects larger than the eye can still injure, as they deform on impact. These injuries tend to be less serious and occur in baseball, basketball, racket sports, and soccer. Sunglasses, eye protectors, and prescription lenses should be made of non-breakable, polycarbonate material. Where impact with large objects may cause head and face well as eye injury (e.g. hockey, football, lacrosse), a helmet/face mask system is best. Protection is important for vulnerable eyes (previous surgery, infection, extreme nearsightedness) or for those with only one good eye (vision less than 20/40).