Mobile Clinic Helping Low-Income Students

Ja'karri Green can't see mosquitoes when they land on his arm, and sometimes he has trouble reading his Japanese comic books. So it was no surprise when the optometrist who came to his Boys & Girls Club camp last week told him he needed to wear glasses."So my seeing is bad?" Ja'karri, 11, asked the doctor, Marianne Mai."Not bad at all!"Mai told him. "You just need a little help."Ja'karri was among two dozen children at the camp in Severn, Md., to get free vision screenings and exams from a mobile clinic operated by the national nonprofit Vision to Learn. With 25 mobile clinics in 12 states, the organization tries to help kids learn by making sure they can see - one pair of glasses at a time.

Vision to Learn was born in 2012 when philanthropist Austin Beutner, then the deputy mayor of Los Angeles, had lunch with state education leaders. When one of them mentioned some students struggled to see the boards in their classrooms because they didn't have glasses, Beutner was surprised that the problem hadn't already met a policy fix. He told The Washington Post that he and his wife, Virginia Beutner, bought an out-of-use mobile clinic from a hospital and staffed it with volunteer optometrists. Vision to Learn was born.Over the next few years, Beutner said, he met boys who did not know trees have individual leaves and girls who had no idea rice has grains. Their vision was just too poor to tell. Students often have no idea that they should be able to see more clearly than they do, said Wade Brown, Vision to Learn's manager of East Coast operations."Kids can tell you their stomach hurts,"he said. "They can tell you their arm hurts. They can tell you their leg hurts. They can't tell you they can't see."

Vision to Learn also tackles the stigma that children with glasses can face. Students may mock kids with glasses for being different, but glasses become cool when sports stars and other prominent people support wearing them. Vision to Learn has tapped celebrities ranging from the Los Angeles Dodgers Foundation to the television personality Mehmet Oz, better known as Dr. Oz, to promote the nonprofit's mission.That mission is important, Beutner said, because schools often consider children with untreated vision impairments to be "problem students" when they actually just don't have all the tools they need to participate in class. For many children, a pair of glasses with the correct prescription sets a path to learning and fitting in with peers."The second path is, you don't get them, you become marginalized,"Beutner said.

Vision to Learn spends an average of $100 on each child, she said. In four states -Maryland, Delaware, Iowa and Michigan - Medicaid reimburses Vision to Learn for students who are covered by that type of insurance.During the academic year, Hollister said, the organization first gets a memorandum of understanding with a school district so it can offer students free vision screenings, exams and glasses.Maryland law requires students to get eye screenings when they start school, in the first grade and in the eighth or ninth grade. Vision to Learn then uses a retinal camera to photograph an eye of each student who will not get a state-mandated screening in school that year, and the photo indicates whether the student needs a full exam.Students who need an exam bring home permission slips to their parents, and Vision to Learn returns to the school in a mobile clinic with an optometrist and optician on board. Usually, Hollister said, 80 percent of students who get exams need glasses, and they can pick their frames from about 30 colorful options.

The optician goes back to the school about two weeks later to deliver and size the students' new glasses. Students get as many free replacement frames as they need for a year.Vision to Learn's biggest challenge has been getting parents to return the permission slips that allow their children to get vision tests, Hollister said. Parents don't always dig into their kids' backpacks to find the papers, she said, and some are hesitant to sign any forms because they may be undocumented immigrants. She said Vision to Learn can serve more students when districts ask parents to opt out if they don't want their kids to get tested, instead of asking all parents to opt in.

As a result of the eye exams and glasses distribution, students who can see more clearly are more engaged in school, behave better and have higher self-esteem, said Amanda Inns, an assistant research scientist at Johns Hopkins University's School of Education."Can you imagine sitting in school all day not able to see what's on the board, not being able to see what's going on?" said Inns, who has worked with and researched Vision to Learn in Baltimore. "At some point, your behavior is going to start to reflect that."Inside the intentionally dark mobile clinic at the Boys & Girls Club in Severn, optician Brandi Stephens asked campers to look into the retinal camera and focus on the image of a hot-air balloon floating above a field of yellow flowers. Vision to Learn avoids using eye drops to dilate the eyes or other invasive procedures, and the organization refers about 10 percent of children to external doctors to be treated for more serious conditions.

The program sometimes struggles to find optometrists who want to work in a mobile office part time, employees said, especially because many of the low-income communities that Vision to Learn serves already face a dearth of eye doctors. The nonprofit now pays optometrists for their work, although the doctors were volunteers when the organization first launched.Mai, the doctor at the mobile clinic outside the Boys & Girls Club, said she joined Vision to Learn in 2016 because she wanted to work with children. She conducts eye exams in the mobile clinic two days each week, calming nervous patients and giving them jelly beans after their testing.

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