Eyes On Learning helped develop the policy and secured significant philanthropic investments for its implementation that started this school year.

With the 2024-25 school year now underway, approximately 500,000 students in Arizona public and charter schools are receiving vision screenings thanks to a new state law and investments from local philanthropic organizations to support a successful rollout. Vision screenings are a critical step in identifying problems that can impede children’s healthy development and educational progress.

While some schools have offered vision screenings in the past, the new law provides rules and guidelines for all public and charter schools to conduct vision screenings for children at school entry (pre-K or kindergarten), in third grade, and again in seventh grade. Schools may also choose to screen children in other or all grades, so the total number of students who will receive screenings this year may be even greater than estimated.

Eyes On Learning, a public-private coalition of partners dedicated to improving the vision health of Arizona’s children, developed recommendations that contributed to the passage of the legislation in 2019 and has been instrumental in bringing significant philanthropic investments and federal funding for its implementation.

“Starting this school year with vision screening as a priority is the culmination of many years of partnership and collaboration,” said Karen Woodhouse, director of Eyes On Learning. “Schools now have the training and tools they need, and hundreds of thousands of kids are being screened to support their best vision health and learning success.”

Why Vision Screening Matters

Vision screening is a critical first step in supporting children’s vision health. For those children who are identified as having a problem, the next step is being referred to an eye doctor for a comprehensive eye exam and follow-up treatment if needed (often glasses).

More than 25 percent of the school-age population in Arizona may have an undetected or untreated vision problem that negatively impacts their ability to learn, and rates of nearsightedness (myopia) in children have spiked since the pandemic.

“Vision health is especially vital in the early grades, when children develop the literacy skills required to be proficient readers, and for success in school in the long run,” Woodhouse said.

While the law requires public and charter schools to provide vision screenings on a regular basis, it is important for parents and caregivers to connect with their child’s pediatrician or primary care provider to include vision screening as part of their regular medical check-ups.

Tools and Training for Schools

As outlined by the law, screenings include visual acuity (near vision and far vision), color deficiency, and depth perception. These screenings require an array of tools and equipment.

Eyes On Learning and the Arizona Department of Health Services (ADHS), which oversees the statewide implementation of the program, began working together after passage of the law to develop the Arizona Vision Kit, which includes everything a school needs to conduct valid, effective vision screenings for students. BHHS Legacy Foundation, Virginia G. Piper Charitable Trust, and Vitalyst Health Foundation supported the implementation effort with significant financial investments to provide the kits to schools for free and cover the cost of specialized devices to screen children age 6 and younger. Over 800 kits have been distributed to public and charter schools in Arizona.

“Many schools don’t have budgets to purchase the equipment,” said Roy Pringle, chief operating officer at Vitalyst Health Foundation, “so Eyes On Learning made sure that the necessary resources would be available for schools.”

In anticipation of the statewide rollout of the new law, Eyes On Learning and ADHS also worked together to reimagine the vision screener certification process. Vision screenings are typically conducted by a school nurse, but any school representative, community partner, or volunteer can now be certified via a new online training program offered by ADHS at no cost to schools. More than 500 school nurses have been certified in the last year. Certification is valid for four years.

“The rollout of vision screenings this year has been wonderful,” said Nadine Miller, RN, director of health services at Mesa Public Schools. “We are excited that our students are being screened and referred to an eye doctor if they need an eye exam. The system is really improved, and that’s good for our students, our staff, and our schools.”

Pilot Program to Streamline the System

To align with the first year of implementation of the new vision screening law, Eyes On Learning also launched a new pilot program that promises to further streamline the vision screening process in Arizona and increase access to follow-up vision care.

EyeSpy 20/20 is a web-based vision screening program that uses game design elements to conduct accurate, validated vision screenings of children’s distance and near visual acuity, depth perception, and color vision for a fraction of the cost of a traditional eye screening. Developed by VisionQuest 20/20, an Arizona-based nonprofit, EyeSpy 20/20 can be utilized on virtually any device, including smartphones, tablets or computers, without the need for expensive screening equipment.

The pilot program will implement EyeSpy 20/20 in approximately 200 schools across Arizona over the next two years, with the long-term goal to offer it to all schools in Arizona at no cost.

“The process is designed to be easy for everyone,” said Jim O’Neil, MD, pediatric ophthalmologist at Phoenix Children’s Hospital and co-founder of VisionQuest 20/20. “Kids just sit down in front of a screen for a few minutes and play a matching game. The results are valid, and schools are able to share this information with families and eye doctors if a child needs follow-up vision care.”

Many philanthropic organizations have provided substantial grant funding for the EyeSpy 20/20 pilot program, including the Arizona Community Foundation, BHHS Legacy Foundation, Burton Family Foundation, The Diane & Bruce Halle Foundation, The Bob & Renee Parsons Foundation, Nina Mason Pulliam Charitable Trust, Virginia G. Piper Charitable Trust, and Vitalyst Health Foundation.

About the Vision Screening Law

Eyes On Learning coalesced the support of many children’s vision, education, and other partner organizations to develop and support the passage of a new state law in 2019, ARS §36-899.10, that requires Arizona public and charter schools to provide vision screening to all students when they first enter school (pre-K or kindergarten), in third grade, and again in seventh grade. Partners included the Arizona Chapter of the American Academy of Pediatrics, Arizona Department of Education, Arizona Department of Health Services, Arizona Lions Clubs, Arizona Optometric Association, VisionQuest 20/20, and Vitalyst Health Foundation, as well as school nurses, school administrators, school boards, and many other philanthropic and community partners. The law is overseen by the Arizona Department of Health Services Sensory Screening Program.

“This coordinated effort to care for our children’s vision health holds so much promise and is going to be life-changing,” said Steve Zabilski, president and CEO of Virginia G. Piper Charitable Trust. “The numerous public, private, and philanthropic organizations that have come together to make this happen is awe-inspiring—it is an absolutely moving example of what is possible when hard work and a concerted focus on improving a social issue unite.”

About Eyes On Learning

Eyes On Learning is a coalition of state, local, and national organizations dedicated to making sure that Arizona children with vision problems are identified early and receive eye exams and follow-up treatment to achieve their best vision health. Launched in 2016, Eyes On Learning is an initiative of Virginia G. Piper Charitable Trust. Learn more at EyesOnLearning.org.

Philanthropic Partners Supporting School-Based Vision Screening for Children

• Arizona Community Foundation
• BHHS Legacy Foundation
• Burton Family Foundation
• The Diane & Bruce Halle Foundation
• The Bob & Renee Parsons Foundation
• Nina Mason Pulliam Charitable Trust
• Virginia G. Piper Charitable Trust
• Vitalyst Health Foundation

Media Contact:

Karen Leland
480-556-7125, kleland@pipertrust.org
Chief Communications Officer
Virginia G. Piper Charitable Trust

Partners:

EyeCare4Kids™ provides professional eye care to low-income, visually impaired children and underserved families.

For more information, visit Eye Care 4 Kids Arizona.

Eyes On Learning Photoscreener Grants are available for eligible early childhood settings, schools, health care offices, and community organizations.

Application and information at http://eyesonlearndev.wpengine.com/resources/eyes-on-learning-photoscreener-grants/.

The distance at which a child views content on a mobile phone may have an effect on their risk for developing myopia over time, according to a speaker at the virtual Association for Research in Vision and Ophthalmology meeting.

“Children using mobile electronic devices employ nearer viewing distances than those often reported in adults, which would make them prone to myopia due to chronic hyperopic defocus,” Renfeng Xu, MD, PhD, said.

Two hypotheses for the cause of myopia include high near work, such as reading a book or looking at a cell phone, and lower levels of retinal illuminance associated with the indoor environment. These two factors can typically co-occur in children engaging in near-viewing activities, Xu said.

Xu and colleagues used real-time monitoring technology to directly quantify environmental light levels and the viewing behaviors of children. The researchers used the VisionApp commercial software to determine the average viewing distances of 20 children using a mobile phone for five different tasks with varying degrees of environmental light.

Children watched a movie with room lights on, watched a movie with lights off, read small text of 8-point type at 1 m, read large text of 16-point type at 2 m and played a video game, all in a random sequence. The app recorded viewing distances continuously for 5 minutes at a sample rate of 15 frames per second, and average distances were reported once per second, Xu said.

The viewing distance remained stable for all the tasks over the 5-minute period, with a mean viewing distance of 24 cm reported across all subjects. This decreased to 21 cm when children read the small-sized text, which might potentially entail the highest risk for near-work-related myopia development, Xu said.

“The mean viewing distance for adults was between 40 cm to 50 cm. The viewing distances for children are significantly smaller than that for adults,” she said.

Further research on viewing behavior is necessary to investigate the differences between Asians and Caucasians, and myopes and emmetropes, both with and without myopia treatment, she said.

Reference:

Xu R, et al. Viewing behavior of children using mobile phones. Presented at: Association for Research in Vision and Ophthalmology meeting; May 6, 2020 (virtual meeting).

Published on May 20, 2020 by Healio.

The Vision Screening in Young Children project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $300,000 with .5% financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.

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