This document outlines the problem of poor vision access negatively impacting student performance and proposes policy alternatives to address it. It notes that 1 in 5 children have undiagnosed vision problems which can lower academic achievement. The optimal policy proposed is a mobile vision clinic that would remove barriers to care by bringing services directly to students, as seen in successful programs in other states. Next steps suggested include securing funding and forming partnerships to implement a small-scale mobile clinic in Clarke County, Georgia.

1. Future in Focus:
Improving Access to
Vision Services
Presented by Shockley Nunnery
Mentor Dr. Neale Chumbler

2. Outline
• The problem
• Policy Alternatives
• Analysis
• Implementation
• Challenges
• Next Steps

3. The Problem
• Barriers to vision services negatively impact performance
inside and outside of the classroom
• Logistical (difficulty scheduling appointments)
• Financial (no insurance)
• Social (parents with disabilities)
http://www.alsj.org/programs.html

4. Poor Vision and School
• 1 in 5 children suffer from an undiagnosed vision
problem
• Uncorrected hyperopia led to perceptibly lower
achievement scores in British study
• Correlation between students’ performance on vision tests
and percentile of grades earned

5. Social Roots of Poor
Vision
• Children in poverty have more vision problems due to
low birth weights and premature delivery
• Low-income and minority students more likely to be
undiagnosed and undertreated

6. Poor Vision and Society
• 52% of at-risk students failed vision tests
• Dropouts 54% more likely unemployed
• Dropouts 63 times more likely to be incarcerated
• Each dropout costs $292,000 in lost taxes and
incarceration costs
• 98% of juvenile delinquents screened failed vision tests

7. Stakeholders
• Students with poor vision
• Healthy students, parents, and teachers
• High schools and school districts
• State and local government

8. Status Quo
• Georgia’s Children’s Vision Improvement and Learning
Readiness Act of 2005
http://www.angelsforsight.org/our-services
• Clarke County
• Kindergarten, 3rd grade, 6th grade
• No screenings in high school
• Referral for follow-up care
/

9. Alternative 1: Mandate
Receipt of Follow-Up Care
• Make parent/caregiver responsible for follow up care.
Schools would need to receive documentation or face
penalties
• Pros
• Makes caregivers responsible
• Least expensive alternative
• Cons
• Similar to Status Quo
• Not likely to increase access to care
• Not politically feasible

10. Alternative 2: Bring Care
to schools
• Bring optometrist or ophthalmologist to school to carry
out follow-up exam
• Pros
• Removes logistical and social barriers
• Medium cost (if applied to one school)
• Cons
• Difficult to carryout on large scale (18 schools in Clarke
County alone)

11. Alternative 3: Automated
Screenings and digital results
• Purchase autorefractor. Screen students and send digital
results to optical shops to create glasses
• Pros
• Removes social and logistical barriers
• Removes difficulty of bringing healthcare workers to schools
• Cons
• May not be technologically feasible
• Autorefractors still not considered best form of screening
• Extra training required for school nurses to administer
screenings

12. Alternative 4: Bus students
to healthcare providers
• Bus students who fail vision tests to optometrists and
ophthalmologist offices
• Pros
• Removes logistical and social barriers
• Reduces trouble of bringing follow-up care to schools
• Medium cost
• Cons
• Inefficient

13. Optimal Policy Alternative
• Mobile Vision Clinic
• Pros
• Removes logistical and social barriers
• Insures consistent care throughout the state
• Long-term sustainability
• More politically feasible
• Cons http://www.jaxdailyrecord.com/showstory.php?Story_id=537090
• Requires coordination between government and private
sector
• Cost

14. Optimal Policy Alternative,
continued
• Florida Mobile Vision Quest
• 140,000 students accessed vision services
• 68% demonstrated an improvement in the classroom
• $660,868.00 government contracts, $252,125.00
foundations, and an additional $182,225.00 in donations
and other forms of revenue
• UCLA Mobile Vision Clinic
• 4,000 students each year
• Georgia Help a Child Smile Mobile Dental Program

15. Next Steps for Georgia
• Convince the State
• Secure government and foundation funding
• Form advisory board to review bids of NPOs
• Transform advisory board into oversight committee

16. Challenges for Mobile
Vision Clinic
• Overcoming inertia
• Convincing government of value
• Finding an NPO willing to take on the responsibility
http://www.igougo.com/journal-j19960-Lawton-The_Land_of_Incongruities.html

17. Next Steps for Clarke
County
• Partnership with Whatever it Takes
• Conduct community-based vision screenings
• Create parent education programs
• Determine the best alternative for a small scale
http://georgiashares.org/member-agencies/

18. Questions
http://www.thingsnerdslike.com/geek-life/positive-self-esteem-ideas-for-children-who-wear-glasses/

19. Works Cited
• Basch, Charles E. 2011. "Vision and the Achievement Gap among Urban Minority Youth." American
School Health Association 81 (10): 599-7.
• Ethan, Danna, Charles E. Basch, Roger Platt, Elizabeth Bogen, and Patricia Zybert.———. 2010.
"Implementing and Evaluating a School-Based Program to Improve Childhood Vision." Journal of School
Health 80 (7): 340-5.
• Ethan, Danna and Charles E. Basch. 2008. "Promoting Healthy Vision in Students: Progress and
Challenges in Policy, Programs, and Research." Journal of School Health 78 (8): 411-5.
• Florida Vision Quest Inc. 2009. Annual Report 2008-2009: Florida Vision Quest.
• Hinkley, Sarah, Erin Schoone, and Benjamin Ondersma. 2011. " Perceptions of Elementary Teachers
about Vision and Learning and Vision Therapy." Journal of Behavioral Optometry 22 (1): 3-5.
• Levin, Henry M. 2005. "The Social Costs of Inadequate Education." Columbia University, The Campaign
for Educational Equity, October 24-26, 2005.
• Sum, Andrew, Ishwar Khatiwada, and Joseph McLaughlin. 2009. "The Consequences of Dropping Out of
High School: Joblessness and Jailing for High School Dropouts and the High Cost for Taxpayers." Center
for Labor Market Studies Publications (Paper 23).
• http://flvq.org
• http://www.jsei.org/About/about_comm_eyeclinic.htm
• HB 34 by Representatives Mitchell of the 88th, Rynders of the 152nd, Graves of the 137th, Bruce of the 64th,
and others. “Georgia’s Children’s Vision Improvement and Learning Readiness Act of 2005”