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:

Up to 28% of Arizona’s children have vision problems that may impact their ability to develop, learn, and acquire critical literacy and reading skills.

PRESS RELEASE: October 25, 2023

PHOENIX, Ariz.—In a collaborative effort to bring a pressing issue to the forefront, Eyes On Learning, in partnership with the College of Health Solutions at Arizona State University (ASU) and Virginia G. Piper Charitable Trust, just released a comprehensive report titled Closing the Gap in Pediatric Eye Care: A Network Adequacy Study. This illuminating study, led by esteemed ASU Professors Dr. Swapna Reddy and Dr. Rizwana Biviji, identifies critical challenges facing children’s eye care services in Arizona.

Key Findings:

• Insurance Limitations: Shockingly, 74% of eye care practices in Arizona do not serve children covered by AHCCCS, the state’s Medicaid insurance plan.
• Provider Scarcity: Among the 703 eye care practices in Arizona, only about 41% provide services to children ages 5 years or younger, and 61% serve children ages 18 or younger.
• Rural Deserts: Four rural counties—Apache, Cochise, Gila, and Santa Cruz—are plagued by an alarming lack of eye care providers that serve children.
• Access Awareness: Surprisingly, more than 90% of eye care practices that serve children do not require referrals from primary care providers, making access easier than many realize.

Why This Matters: Vision problems are a silent crisis among children. Untreated vision problems can have detrimental lasting academic and personal consequences. As Arizona moves toward mandatory vision screening in public schools, it’s expected that at least 25-30% of screened children will be identified with vision problems—and they are the most inexpensive to treat with proper follow-up.

“Our mission is to ensure every child in Arizona has access to quality eye care. This study underscores the disparities and challenges we must overcome to make this a reality,” said Karen Woodhouse, director of Eyes On Learning.

“This study serves as a crucial call to action for improving children’s access to essential eye care,” said Dr. Rizwana Biviji, professor, ASU College of Health Solutions. “It provides a roadmap for addressing disparities in pediatric eye care.”

Findings from this study will be unveiled at the Children’s Vision Health Forum on October 26, 2023 where Dr. Sandra Block, President of the World Council of Optometry, will provide the keynote. For more information visit this link: Children’s Vision Forum.

About Eyes On Learning

Eyes On Learning is dedicated to making sure that children with vision problems are identified early and that they receive eye exams and follow-up treatment to achieve improved vision health. For more information: eyesonlearning.org

About ASU’s College of Health Solutions

The College of Health Solutions at Arizona State University, established in 2012, translates health research and discovery into practice and prepares tomorrow’s leaders to address the challenges facing people and communities to stay healthy, improve their health, and manage chronic disease. For more information: chs.asu.edu

About Virginia G. Piper Charitable Trust

Virginia G. Piper Charitable Trust supports organizations that enrich health, well-being, and opportunity for the people of Maricopa County, Arizona. Since it began awarding grants in 2000, Piper Trust has invested more than $711 million in local nonprofits and programs. Piper Trust grantmaking areas are healthcare, children, older adults, arts and culture, education, and religious organizations. For more information: pipertrust.org

MEDIA CONTACTS:

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

Weldon Johnson, weldon.b.johnson@asu.edu
Communications Specialist, College of Health Solutions, ASU

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

For more information, visit Eye Care 4 Kids Arizona.

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.

Visit their new site and new resources.

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.

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/.

It will provide funds to promote healthy vision for kids.

(PRESS RELEASE) CHICAGO – The National Center for Children’s Vision and Eye Health at Prevent Blindness (NCCVEH), celebrating its 10-year anniversary, announces that a second year of funding was received from the federal Health Resources and Services Administration’s Maternal and Child Health Bureau for $300,000 to support the center’s ongoing work to improve eye health in at-risk, minority, and vulnerable populations of young children by the year 2021.

A key project for the funding is the continuation of the “Better Vision Together- Community of Practice” program, a peer-to-peer mentorship and learning opportunity for eight communities and states including Texas, Arizona (2), Idaho, Massachusetts, Minnesota, California and Florida. Through Better Vision Together, teams are addressing all components of the vision and eye health system for children, including vision screening and access to eye care, parents/caregiver education and engagement, data collection, and professional education.

The community of practice promotes this work through coalition building with the education, medicine, public health, community organization, and child care sectors. Populations served by the teams include Hispanic, Native American tribes in cities and reservations, Asian, African American, immigrants from Iraq, Congo, Burma, Somalia, Afghanistan, Laos and migrant farm workers.

To date, Better Vision Together partners have completed the following actions:

• Eyes on Learning, Virginia G. Piper Charitable Trust (Phoenix, Ariz.) – Hosted the Children’s Vision Health forum for 60 stakeholders and launched a public awareness campaign aimed at parents and caregivers around children’s vision (“Children Don’t Know What they Can’t See”).
• Haverhill Promise of Children’s Vision, Haverhill Public Schools and Haverhill Promise (Haverhill, Mass.) – Created, produced and distributed book marks and book plates with the message for parents and caregivers: “Healthy eyes are ready to read; have your child’s eyes checked today.”
• Improving Childhood Vision Health Task Force, Minneapolis Public Schools Office of Early Childhood Education (Minneapolis, Minn.) – Has begun implementing a new vision screening program for 2,500 Head Start students to be conducted by Lions Clubs volunteers.

The NCCVEH at Prevent Blindness is supported by the federal Health Resources and Services Administration’s Maternal and Child Health Bureau under grant number H7MMC24738. The total award amount for the “Vision Screening in Young Children” grant is $300,000 (percentage financed with nongovernmental sources .5%). This information or content and conclusions are those of the NCCVEH and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

In 2009, the NCCVEH was established to develop a coordinated public health infrastructure to promote and ensure a comprehensive, multi-tiered continuum of vision care for young children. The NCCVEH continues to work with leading, volunteer advocates and professionals in ophthalmology, optometry, pediatrics, public health, and related fields, to review the current scientific literature, explore best practices, establish partnerships, develop data, and gain consensus on the best approach to children’s vision and eye health.

Additional planned projects for this grant period include a social media awareness campaign targeting minority parents and caregivers, and development of an online Family Resource Tool Kit to be distributed to early childhood care and education centers.

“In 1908, Prevent Blindness was founded as a public health advocacy organization, specifically to address children’s vision issues,” said Jeff Todd, president and CEO of Prevent Blindness. “Thanks to the generous support of MCHB, we can continue to have a positive impact on children and their future across the country.”

For more information about the National Center for Children’s Vision and Eye Health at Prevent Blindness, or the Better Vision Together- Community of Practice program, please visit https://nationalcenter.preventblindness.org/better-vision-together or contact Donna Fishman at (800) 331-2020 or dfishman@preventblindness.org.

Published August 15, 2019 by INVISION Staff

Arizona schools will soon begin giving kids free vision screenings, thanks to a new law.

The legislation, introduced by state Sen. Sylvia Allen, R-Snowflake, requires schools to give vision screenings to:

• Students just entering school.
• Students who receive or are being considered to receive special education services.
• Students whose teachers have requested a screening.
• Students not reading at grade level by third grade.

Gov. Doug Ducey signed the vision screening law, Senate Bill 1456, on June 7. It goes into effect in late August.

“When a child can’t see properly, they will of course struggle in school,” Allen said. “And young children don’t necessarily know they have vision issues. They may think what they’re seeing is normal vision.”

Other states, like Illinois and Texas, already require vision screenings for younger children, according to the National Center for Children’s Vision and Eye Health.

Advocates say the ability to see clearly is critical in a child’s education: 80% of a child’s learning is done visually, according to Eyes on Learning, a nonprofit that advocates for early childhood vision screenings in Arizona.

It’s unclear exactly how this new law will be implemented in schools. Originally, the bill came with $100,000 to help facilitate the new screenings, but a floor amendment by Republican Rep. Nancy Barto stripped the requirement of that funding.

The law requires that a trained school official or volunteer administer the tests. District and charter schools must notify parents about their child’s test results if they fail, and parents can opt their child out being tested.

Reach the reporter at Lily.Altavena@ArizonaRepublic.com or follow her on Twitter @LilyAlta.

February 7, 2019

PHOENIX – The ability to see clearly is critical for young children, particularly when they’re learning to read.

The nonprofit Eyes on Learning Vision Coalition aims to have all preschool-age children in Arizona screened for vision problems and for those needing it, to receive an eye exam and follow-up treatment for better vision health.

Nicol Russell, deputy superintendent for early childhood education of the Arizona Department of Education, says taking her pre-school daughter to get a vision screening at a local school district was, literally, an eye-opener.

“They used a machine to take pictures of her eyes and said, ‘Do you notice an issue with her vision at home?’” she relates. “I said, ‘No,’ and they said, ‘Well, it looks like she has a pretty significant vision problem.’ And I was sort of dumbfounded. I said, ‘I had no idea.'”

Russell says until that point, her daughter had shown no signs of difficulty with her vision and had never complained about not seeing well.

The pediatric ophthalmologist who examined Russell’s child recommended glasses.

Russell says the screening results have made a significant difference in her daughter’s life, allowing her to see clearly for the first time.

That’s exactly the result Eyes on Learning wants, according to Karen Woodhouse, vision screening director for the Eyes on Learning Vision Coalition.

She says the coalition includes local, state and national representatives from a variety of medical, educational and social service agencies.

The coalition works with school districts and charter schools to ensure vision screenings are available. Woodhouse says the goal is for all Arizona children to be able to read and learn.

“We want to make sure that kids have their best vision health, because vision health is critical for a child’s early development,” she stresses. “It’s really important for learning in school, and especially critical for kids who are starting to learn to read.

Russell says since her daughter put on her new glasses, the change has been remarkable.

“We thought it would be a struggle for her to keep it on,” she relates. “She’s only three. She won’t like it.

“She hasn’t had any issues. I said, ‘Do you need to take a break?’ She said, ‘No, I can see!’ We had no idea she couldn’t see before that.”

The Eyes on Learning Vision Coalition is funded by the Virginia G. Piper Charitable Trust and other community partners.

Mark Richardson, Public News Service – AZ

Lions Clubs are found in many Arizona communities and provide volunteer vision screening upon request through the Lions KidSight program. Contact your local Lions Club for more information.

“When NICHQ asked me to be a part of the quality improvement team, I was eager to join. It seemed that this team had a methodical, realistic way to help other families, and that has become my passion,” says Heather Joy Magdelano, a parent partner on NICHQ’s Improving Children’s Vision project.

Parents of children with special health needs become experts on their children’s condition in a way that doctors and administrators cannot. Their countless hours on the front line, navigating the healthcare system and other community resources, gives them invaluable insight into how these systems work (and do not work) for them. That is why NICHQ emphasizes the value of utilizing the parent/family perspectives in change efforts.

“We make it a point to have at least one family representative, usually a parent, on each of our project teams,” says NICHQ Director of Programs Meghan Johnson, MSc. “Their perspectives, opinions and ideas help ensure that the team creates improvements that will work ‘in the real world’. Too often patients and families have ideas on how to improve the health system, but there is nowhere to share or implement them.”

Heather Joy Magdelano is a parent partner on NICHQ’s Improving Children’s Vision project. She has two deaf and blind children and is a leader in advocating for families with deaf and/or blind children. Both of Magdelano’s children have a rare genetic syndrome diagnosed at birth, yet the oldest was not diagnosed with a vision problem until he was five months old.

“Most pediatricians do not check for vision problems at such a young age,” says Magdelano. “If you are concerned, you may have to push to get vision checked, but you should because early intervention is critical.”

Magdelano received news of her son’s vision problem by a call from the Foundation for Blind Children.

“I was more than surprised to receive this call out of the blue. No one from my pediatrician’s office had talked to me about vision problems,” she recalls, as well as feeling validated, as she knew something was not quite right but did not know what it was.

Magdelano’s son has cortical vision impairment where the brain does not process what the eyes see. It often goes undiagnosed. After needing to advocate for her own children, Magdelano says she did not want others to go through what she had experienced.

“When NICHQ asked me to be a part of the quality improvement team, I was eager to join. It seemed that this team had a methodical, realistic way to help other families, and that has become my passion,” says Magdelano.

Magdelano is a perfect example of what NICHQ looks for when recruiting parent partners. According to Johnson, it’s best to look for family members who are passionate about the subject matter and ready to share their experience and advocate for others.

“A family partner is not just a token or a nice to have,” says Johnson. “They are equal members of the team. Their lived experience is just as important as that of the medical, quality and administrative experts.”

Family partners often change the trajectory of a proposed improvement idea, making it more successful. For example, Johnson recounted an instance when a NICHQ team was working on a tool for families to communicate outcomes on a daily basis. An online daily survey was proposed. However, the two family partners pointed out that it was difficult or impossible to get online daily to do this. Some didn’t have a smart phone or a computer, others didn’t have the time to log on and fill out the survey. One family partner suggested that families text their answers to the team. To try out the idea, the improvement team bought inexpensive phones for those who needed texting capability. It worked! More people communicated outcomes, which of course informed the project and made it more successful.

In another example, Magdelano’s team was attempting to create a letter that pediatricians could give to families, recommending that they see an optometrist. The two parent partners had very different views on the letter’s language. This reinforces the importance of remembering that one or two parent partners do not necessarily represent the views of all parents. These parent partners decided to run the language by their friends who had children with the same condition, but were not part of the team. In the end, family members on and off the team were instrumental in designing the letter. In turn, the letter will help more families obtain vision testing which is often overlooked.

There are some barriers to engaging family partners on quality improvement teams. Attendance is at the top of the list and is influenced by lack of time, funds, transportation, childcare and scheduling.

“We need to do everything we can to avail ourselves of family members’ perspectives so that we can make real, sustainable change,” says Johnson. “This means scheduling meetings around family partners’ schedules, providing childcare, using technology to hold virtual meetings when necessary, and even paying family partners.”

Magdelano suggests that teams help keep family partners engaged by sending them notes from the meeting and having the team leader call to catch up. “Calls are important,” says Magdelano. “There is so much more communicated through talking to someone versus reading notes.”

Magdelano reports myriad benefits for her and the community just by being a part of the NICHQ team.

“I have never been in a quality improvement process and it is interesting to see the issues from this perspective,” she says. “It got me to step out of my box and think in a different way. It also helped me see where a quality perspective could be beneficial in other community organizations.”