At the vision clinic at the Youth Heart Health Center in Oakland, Ka Yee So, an optometrist, is working with Angelica Lara, 5, a young patient diagnosed with amblyopia, also known as lazy eye, considered the most common cause of visual impairment in children. 

So is showing Lara how to use a “pirate patch” to obstruct the vision in her better seeing eye, in order to strengthen the visual development in her poorer sighted eye. With each subsequent visit, So said, the asymmetry of the vision between Lara’s two eyes has minimized. Once hesitant to wear glasses, Lara said she now really loves her glasses.

A study published last year showed that 20 percent of all school-aged children in this country have vision problems and low-income and minority children are disproportionately likely to have unmet vision care needs. Although vision screening is common in schools, So said classroom exams are designed to check for sharpness of vision or nearsightedness or farsightedness. These exams neglect to check a student’s close-up skills needed for reading, such as tracking, focusing and binocular vision.

“Children can pass a screening at school and still have vision problems that affect their learning and school performance,” So said. “Some students will even memorize the eye charts in order to pass the test, but if their vision problems go undetected or untreated, they often struggle in school.”

Launched in 2017, Oakland Unified School District’s vision clinic at the Youth Heart Health Center, is the first center for vision care to be based at a school in the Bay Area. The clinic is located in the same complex as Las Escuelita Elementary, is adjacent to Metwest High, and located across the street from the Dewey Academy. The clinic serves both Alameda County students and members of the community between the ages of 3-21 and provides both comprehensive vision exams and prescribing eyeglasses if necessary.

Amy Blackshaw, manager of school based health centers at La Clinica de la Raza, which supervises the vision center, said services are made possible through a grant from OneSight, a vision care non-profit that provides vision care access to communities worldwide. 

“In 2016, we were approached by staff at Oakland Unified and encouraged to apply for a OneSight grant to open a school-based vision center,” Blackshaw said.

This year, OneSight also partnered with a non-profit, Advanced Center for Eye Care (ACE) in Bakersfield, to open four school-based vision centers within the Bakersfield City School District. Although OneSight had been working with Bakersfield schools to provide annual vision exams to local students, the new school-based vision centers provide an important bridge from detection to eye care for families that may be uninsured or underinsured.

While there are some nonprofits such as Vision to Learn, a Los Angeles-based nonprofit that provide mobile vision clinics that visit California schools one day each year, the OneSight model works to provide follow-up care, flexibility with appointments and the opportunity for vision therapy if needed.

“We want to work with school nurses and members of the community to be a referral site for any child in Alameda County that fails their mandatory vision screening,” Blackshaw said.

While grant funds from OneSight help to establish school-based vision clinics, Blackshaw said the goal is for centers like the one in Oakland to become self-sustaining.

“Our goal, which is a work in progress, is to become sustainable through additional grant funding and by billing third-party providers such as Medi-Cal,” Blackshaw said. “OneSight will continue to provide us with eyeglasses for students.”

The vision clinic also recently launched a public awareness campaign in conjunction with AC Transit and hopes to expand outreach and screenings to area preschoolers.

 “There’s a real need to increase awareness about the importance of preschool vision exams,” So said.

A 2017 report found that close to 175,000 American preschoolers struggle with common but untreated vision problems, and that number is expected to jump 26 percent by 2060. The report noted the vast majority of untreated preschoolers (70 percent) had blurred vision due to nearsightedness or farsightedness, a condition that can be easily corrected with eyeglasses. The report also found that Latino preschoolers accounted for 38 percent of untreated vision problems, followed by 24.5 percent of African American preschoolers.

From 2015 to 2060, California is expected to have one of the highest rates of vision impairment among children (26,600 in 2015 and 38,000 in 2060). 

“Since transportation is also a huge barrier for many families, we’re also working on a shuttle service that would bring children from other school sites in Alameda County to our vision clinic,” So said. “We know that uncorrected vision problems in children can impact socialization, coordination, school performance and a child’s ability to participate in sports and recreational activities.”