Seeing is learning

September 29, 2021
an optometrist conducts an eye exam
Optometrist Catherine Kirby finds satisfaction in offering vision care to kids who might not otherwise get their eyes checked. Photos by Sarah Pack

Imagine that your eyesight is so poor that even the big “E” on the eye chart is fuzzy – not to mention the other, smaller letters.

Now imagine that you’re a child. With no other frame of reference, you don’t even realize that the “E” should have sharp, crisp lines. You can’t decipher anything the teacher puts on the board, and you can’t understand why the other kids can. School might start to seem like it’s just not for you.

In 2012, the nonprofit group Vision To Learn set out to provide eyeglasses to children in underserved schools with the expectation that improving their vision would help them to improve their grades.

Now, with the encouragement and support of the local community, led by Henry J. Blackford III, the group is embarking upon a pilot program in Title I Charleston County elementary schools.

Since launch of program
in Charleston County:

Children screened: 1,778

Did not pass screening: 647 (36%)

Children examined to date: 116

Glasses prescribed: 91

The Medical University of South Carolina is providing support during this pilot year by funding a mobile exam van – essentially, an eye doctor’s office on wheels.

The process begins when the Vision To Learn program manager or optician screens all children at a school, unless their parents have opted out. Then, students referred by the initial screening are scheduled to visit the Vision To Learn eye care team when it comes to the school with its mobile clinic. Inside the mobile clinic, an optometrist conducts eye exams to determine if each child needs glasses – if so, students get to choose their frames on the spot.

A few weeks later, the team returns to fit each child, and the children leave with brand-new, free glasses. The optometrist also provides referrals to multiple providers around town for children in need of follow-up care. The team can examine 15 to 18 students each day.

Getting glasses for a child who can’t see might seem like an obvious fix, but many children from low-income communities haven’t seen an eye doctor. In California, for example, two-thirds of the Medi-Cal (California's version of Medicaid) students that Vision To Learn helped hadn’t gotten any eye care for the previous four years.

Plus, said Vision To Learn optician Joe Venzie, parents tend to keep their kids closer to home nowadays and use more tablets and phones, so they don’t necessarily notice as quickly that their kids can’t see far away. He and optometrist Catherine Kirby, O.D., recently examined a child whose vision was so poor that the big “E” was fuzzy.

“They don’t know what they’re missing,” Venzie said.

a man adjusts a child's head to the right spot for the eye exam camera 
Optician Joe Venzie directs a student to place her forehead against the bar so a picture of her eyes can be taken. In addition to typical optician duties like helping patients select frames and ensuring the glasses fit properly, Venzie soothes anxious kids and engages with those waiting for their turn with the optometrist.

Many of the children are nervous when they get into the van because they don’t know what to expect, they said. One recent child seemed apprehensive about reading the eye chart for her, Kirby said. But as she clicked through the lenses to correct his vision, he suddenly came to life. Turns out, he wasn’t nervous about reading the chart. He just couldn’t see it.

Most of the children Kirby has seen so far have either never had glasses or had older, broken glasses, and so they haven’t worn them for two or three years, she said. She likes that she can intervene in these children’s lives and possibly change the trajectory of their school careers.

“It’s going to set them up for success long term,” she said.

That is precisely MUSC’s interest in assisting the pilot project, said Andrew Eiseman, M.D., chairman of the MUSC Storm Eye Institute.

“Our primary interest is to help kids see so they can learn,” he said.

Researchers from the University of California Los Angeles and Johns Hopkins University have separately looked at the effect of receiving eyeglasses on children’s grades and standardized tests and found that students’ scores improved after they got their glasses.

“The idea is to reach out to children who otherwise most likely would not receive any eye care to provide them with a screening examination and a pair of glasses free of charge to enhance their ability to learn. The mantra is, ‘If you can’t see, you can’t learn,’” Eiseman said. “MUSC, including our senior leadership, our children’s hospital and the Storm Eye Institute, all 100% agree with that philosophy.”

a box of frames sit on a table waiting for a child to choose them 
A selection of colorful frames are available for the children to choose from.

Caroline Brown, chief external affairs officer at MUSC, said MUSC’s support during the pilot year is all about addressing health disparities. Patrick Cawley, M.D., MUSC Health system CEO and vice president for Health Affairs, University, agreed.

“This is a tremendous opportunity to help students who have, for years, gone without basic eye care – to the detriment of their academic achievement. Every child deserves the opportunity to reach their full academic and wellness potential,” Cawley said. “This program is a great fit with our mission to improve continuity of care for children in need throughout the region, and we look forward to working with other community eye care providers to fill this important need for our community’s children.”

During its decade in operation across the country, Vision To Learn has found that 87% of its students are children of color and 89% live in poverty. Most of them have not seen an eye doctor. A solution as simple as eyeglasses, provided early in a child’s school career, can help to change how the child performs in school, which then has a ripple effect on everything from the child’s self-esteem to the possibilities that open up after school.

“We are thrilled to be bringing service to students in the Charleston region,” said Vision To Learn president Ann Hollister. “By providing free eye exams at school, Vision To Learn helps students get the glasses they need to succeed in school and in life.”

The Storm Eye Institute has in the past provided screening services in schools on a small scale. The Lions Club also focuses on vision and provides some in-school screenings. But Eiseman said the needs far outweigh what local groups have been able to provide.

“There’s so much need that even with Vision To Learn and Lions and Storm Eye continuing their programs, there are still more children who need this service,” he said.

A van is adorned with graphics advertising the nonprofit group Vision to Learn and the support provided by MUSC Health, MUSC Children's Health and the MUSC Storm Eye Institute 
The mobile clinic visits an elementary school in September.

Vision To Learn has finished exams at Sanders-Clyde Elementary on the Charleston peninsula and was at North Charleston Elementary on Monday. One by one, children climbed into the van and went through the typical eye exam – with the addition of some awesome kid jokes – and then got to pick the frames they liked best. The van will return in about a month with the finished glasses, and Venzie will ensure a proper fit for each child.

At Sanders-Clyde, more than 30 students were given referrals to a list of potential providers around town to get more comprehensive exams.

Seventy-eight Sanders-Clyde students will be getting new glasses in a couple of weeks. That’s 78 kids who will realize that, yes, you can see individual leaves on trees. You can see the ball across the field. You can see the letters on the eye chart. And yes, you can see what the teacher is writing on the board.