Antonio is clear about his future: he’ll take the SATs, apply for college scholarships to study software engineering, and spend his off-hours developing apps with his friends. Antonio also has clarity about the fact that he is homeless and has little to no support from his family. Yet his most immediate issue is the one thing that isn’t clear: his vision.
The last time I wore glasses was a long time ago; I got jumped when I was 15 and they were broken,” he says. “I do my best to get really close to things to overcome the poor eyesight. A lot of the time I rely on my not-so-bad eye. If I close my left eye, everything is like a Picasso painting, just so blurry and colorful.”
As a resident of a Manhattan shelter for homeless youth run by Covenant House, Antonio is sure to qualify for financial aid, especially since he scored an impressive 2120 on his PSATs several years ago and is already taking courses offered at the shelter. His residency at Covenant House also qualifies him for a free eye exam and new pair of glasses, courtesy of Helen Keller International (HKI).
Meghan Lynch is national director of HKI’s ChildSight program, and she has a clear plan for the future of vision care in the United States. A public health, poverty and social justice policy veteran, Lynch is deeply bothered by the fact that the eye health crisis in the U.S. is mostly ignored.
“Far too many kids don’t have the glasses they need. They can’t see properly, and they aren’t able to reach their full potential as a result,” says Lynch. “This is a glaring failure of our public health and education systems. So I’m very proud that ChildSight provides a simple, flexible and affordable solution."
Lynch and her colleagues at HKI are at work on a bold plan to expand the 24-year-old ChildSight program. Currently operating in New York, California, Connecticut, New Jersey and Ohio, the program provides vision services to students and at-risk youth, who for any number of reasons do not have the resources or opportunities to receive basic vision care. Just in New York City alone, ChildSight provides vision services to more than 30,000 low-income students annually. And in the last school year alone, the program distributed nearly 15,000 free pairs of prescription eyeglasses across all five states.
“Regardless of gender, race, ethnicity, socioeconomic background or nationality, there is an unmistakable need for routine, comprehensive vision care,” Lynch affirms. ChildSight has been a pioneer in this regard and is a principle player in solving the problem.
“In the arena of public health in the U.S., there are few issues where the solution is so tangible,” says Lynch. “With this program, we show up at a school or other facility, we provide vision services, we give out glasses, and a problem is fixed.” It’s also a relatively inexpensive solution. Through economies of scale, partnerships and the tireless work of small teams of managers and optometrists, HKI has kept the cost of delivery to about $25 per child.
Since 1994, ChildSight has screened more than 1.9 million vulnerable students and delivered free prescription eyeglasses to more than 275,000 children throughout the U.S. Despite these achievements, however, an estimated 4 million children and 16 million adults nationwide still suffer from impaired vision. And these uncorrected vision problems almost always result in significantly reduced quality of life, including lost educational and employment opportunities. HKI aims to correct this unfair disadvantage by reaching low-income youth and their families in as many states and communities as we can.
Nick Kourgialis, HKI’s longtime vice president for eye health, says there are several issues that ChildSight commonly identifies in its young clients. “The primary cause of vision loss among the students we serve in the U.S. is refractive error: near-sightedness, far-sightedness and astigmatism.”
For most children, these conditions manifest gradually, typically around middle school ages, when the world starts to look a little blurry to them. Many assume that everyone else sees the world the same way, and they don’t realize they have a vision problem. So they struggle to adapt by squinting, sitting closer to the blackboard and asking friends for help until, if they’re lucky, someone actually conducts a vision screening and provides them with the eyeglasses they need. ChildSight fulfills this need in a very cost efficient and effective manner, reaching out to students within their schools and removing whatever barriers they might normally encounter in seeking help for their vision loss.
When a family isn’t even aware of a child’s vision problem, it is the most dramatic and heartbreaking. Such was one case described by Program Manager Jorge Valdez in Los Angeles: “The student put on glasses for the first time, and his mom was there, and he said, ‘Whoa, Mom, that’s what you look like!’ The mom started crying. Up until then, this kid’s mom had just been a blur. It was profound.”
“School districts throughout the United States recognize the important link between clear vision and academic achievement,” notes Kourgialis. “That’s why most states and municipalities have regulations in place requiring that students receive vision screenings in selected grades. Unfortunately, in most instances, local governments do not devote the necessary resources for providing these services. The resulting unfunded mandate means that children do not receive the vital eye health services they need.”
This situation is a real shame, because the majority of vision issues are generally easy to correct. “Long ago, there were nurses in most schools who were able to do the screening,” Kourgialis adds. “But routine vision services became rare as the funding became scarce.”
The changing economy and steady increase in income inequality have led to a shift in traditional assumptions about poverty and where it is concentrated. Suburban communities are seeing a growing proportion of residents in need of financial assistance and a helping hand.
“The struggle with obtaining proper eye care for a lot of low-income families is, if it's not an actual emergency, working families don’t have the time or the money to go get services. I really see ChildSight as a logical and straightforward support for low-income families,” says Lynch. “One of the really nice things about the program is that, since prescriptions are active for a year after they are written, if any students who we've seen lose their glasses, misplace them, break them, whatever, we'll replace them.”
ChildSight eliminates the barriers to kids getting the glasses they need, but we also needed to crack the code on getting kids to want to wear them. So we invested time and energy into finding the right frame partners who could keep up with what’s fashionable while keeping costs down. Each summer, when ChildSight staff come together for meetings and trainings ahead of a new school year, the centerpiece of the event is the selection of the year’s new frames.
“Your face is your prime real estate,” says Lynch. “We’ve got to keep the frames cute so kids are excited to wear them.”
As Kindal Adams, who runs the program in New Jersey and has been with ChildSight since 2001, notes, “It’s an easier sell because the product is better. When I started, we had one frame in multiple colors. It was a standard “Harry Potter” frame, just round. We would bring the frames in three different sizes, and boxes and boxes of lenses. We made the glasses on site. Efficient? Absolutely. Effective? Not really. I would get calls from nurses saying ‘Oh, I looked out the window and I can see that the glasses are on the roof because the kids don’t like them.’ To be an effective provider of services, we needed to change our product, and that’s exactly what we did.”
So what’s next?
Can you imagine if 20 million Americans could suddenly be more productive in school, on the job and at home with their families? HKI can. That’s why we are working hard to expand and adapt our vision program in more areas of the country and to serve more vulnerable populations. We know this outreach is especially important given the scale of the issue, and because the real action is always on the front lines in public health. We are also confident in the strength of our partnerships, the importance of the human interaction we foster and the quality of our service.
“We've got more than 60,000 homeless people in New York City. Many would greatly benefit from a simple pair of glasses, which — for this population — is a workforce development tool,” says Lynch. “When we learned that homeless veterans were among those facing barriers to vision care, we knew we had to take action to serve them.”
HKI was originally founded by Helen Keller and businessman George Kessler to assist soldiers who had been blinded in the first World War. “Being true to our earliest mission and fulfilling Helen’s own commitment to helping vulnerable people fulfill their potential are very meaningful for us,” adds Lynch. “So we’ve reached out to new partners and have just recently screened and distributed glasses to more than 50 homeless vets in New York. There is so much more good work to be done and we know HKI can do it best.”
With two new programs opening in Minnesota and Wisconsin in 2018, HKI is on track to double our current reach to 10 program areas over the next 5 years. We are seeking not only to increase the number of school children screened annually from 60,000 to 120,000 during this period, but also to reach additional vulnerable groups, including homeless families, underserved veterans, at-risk LGBT populations, Native Americans and low-income seniors. By 2025, we hope to have established programs in the 25 states with the highest rates of child poverty in the U.S.
The strength of HKI’s model is that we have always worked in close partnership with schools, government agencies, nonprofits and community organizations. We bring the ChildSight program to them; we listen to teachers, nurses, and community workers; and we make it as easy as possible to receive our services. ChildSight’s program managers live and work in the communities that they’re empowering; they know both the needs and the nuances of their neighborhoods.
As an international development organization with a 103-year history, HKI is also working to prevent blindness in 20 countries in Africa and Asia by treating cataract, diabetic retinopathy and refractive error. We’re uniquely able and equipped to bring the power of that expertise to making bigger strides for eye health in the U.S.
Tonya Daniels, ChildSight’s manager New York and on staff with the program from the beginning, says, “We know this program works, but we are always working to make it better. As part of a huge health and humanitarian organization — an American one and founded by a great American woman — we’re hands-on and in-the-field here in the U.S.: in schools, in shelters, in low-income neighborhoods. I’m bringing eye health directly to our clients, right to where they are and wherever they face obstacles. I actually bring it myself in a suitcase. It’s got wheels and I’ve got legs. So I'm going to keep on bringing it!”
HKI’s President and CEO Kathy Spahn notes that HKI is committed to forging more partnerships to support ChildSight’s growth. “Based on our experience, it is clear that we will need to harness the combined skills and resources of philanthropy, government and business to tackle this urgent issue in a sustainable way. We have demonstrated success with an integrated approach through our international work, and we’re beginning to see opportunities emerge to address vital eye care needs in the U.S. through a great variety of public-private partnerships. HKI will maintain high clinical standards, low cost service, and continued educational outreach to children, their families and their communities about the importance of corrected vision. We will keep working hard to eliminate the primary barriers that stand between them and their realized potential.”
Meanwhile, Antonio’s next steps are beginning to come into focus, and he is moving ahead. “I love computers, and it’s my lifelong dream to work with them,” he says. “My eyes really impair my ability to do things on the computer, because it’s really hard to see. With my new glasses, I’ll actually be able to see things, be able to react to things.”
Antonio was visibly excited the night he took his eye exam. Two weeks later, he had his glasses and, with them, the ability to walk clear-eyed and confidently into his future.
Learn more about ChildSight's impact, including testimonials from the students we've served.