Children’s Vision Screening

DEVELOPMENT OF A LIONS KIDSIGHT USA PROGRAM

Lions Clubs International

What is KidSight?

A Lions Program that uses a hand-held camera vision screening device (several options) for pre-literate children age 6 mos. to 6 years

• Detects risk factors for amblyopia, refractive error, etc., before a child starts primary school. About 14% are referred.

• These visions problems after age 7 are much, much harder to treat.

• Screening results are instantaneous• Cameras can be used by volunteers;

cost about $6,000 to $7,500

Background

Programs in several states started in the late 1990s with the MTI Photoscreening camera.

Major programs started in TN, IA, IN, and CO – with three of them coordinated with help of eye departments at major universities – Vanderbilt, U of Colorado, and U of Iowa (major Lions eye centers at Vanderbilt U and U of Colorado).

University partners added credibility and did much of the photo interpretation for the Polaroid images from the MTI camera.

Background

Program was given LCIF Core 4 Program “Priority Status” in the late 1990s, which resulted in $2 million+ in grant funding to start statewide programs.

Grants went to NJ, NY, WY, CO, MI, VA, LA, and several others as a result.

Programs now screen upwards of 500,000 kids under 7 each year. University partners not needed today to interpret results of photos; referral criteria built into the device’s software.

LCIF provides matching grants for cameras – expansion of programs or to replace older cameras.

Lions KidSight USA Created

A National Survey of USA Lions conducted in the spring 2014 to identify need and direction for a national program.

90%+ of respondents favored children’s vision screening.

National planning committee established by Lions top leadership in the USA, headed by PID Dr. Ed Cordes (Optometrist from NY) and supported by Dr. Hauser Weiler (Ophthalmologist from VA).

A national coalition founders committee meeting was held Aug 16, 2014 representing NY, NJ, VA, IA, IN, CO, CT, TN, KS, and GA to determine next steps.

The official roll out of the program took place at the USA/Canada Lions Leadership Forum in Puerto Rico in September, 2014.

Lions KidSight USA Created

LCIF provided a seed grant for founders meeting and to support program launch.

National website is being created.

The committee created suggested models suitable for all program sizes to promote best practice standards.

Name Lions KidSight USA was approved. Logo developed.

Goal of national program is to build the capacity to screen all kids under age 7 by 2018.

Funding Of Program

2 equipment companies became partners at $50,000 each over 3-5 years.

Opportunity potentially to raise funds nationwide from non-Lions in the USA, but would be restricted to the program.

LCIF will need to invest some modest funds in the next two years, but this may not be significant if corporate funding happens as expected.

Goals of Children’s Vision Screening

Primary Goal – Detection of Amblyopia and its Risk Factors

Secondary Goal – Need for Eyeglasses Detect Abnormal Vision Risk factors to visual development Timely treatment with greatest benefit

Effects of Poor Vision In The Young

Poor literacy Behavioral Disorders No participation in sports Poor socialization Other social/behavioral issues

HISTORY of Screening Methods

Tumbling “E” and Snellen Charts Titmus Binocular Screener MTI PhotoScreener Auto Refractors Modern Binocular Automated Screeners

iScreen

PlusOptix

Welch Allyn SPOT

AMBLYOPIA

Decreased vision in one eye relative to the other Caused by

Congenital Cataract

Crossed eyes – strabismus

Unequal refractive error – one strong & one weak Detect early, treat before age 6 Little benefit of treatment after age 8

When Should We ScreenWhere Should We Screen

Lions should screen children beginning at 6 months Biggest benefit: 6 months to 6 years of age Day care centers/nursery schools School screenings Do NOT screen adults – does not detect adult eye

disease like Glaucoma, Macular Degeneration, etc.

What Should We Use

Strive for the best devices available Lions KidSight USA Suggests The Following

Characteristics Ease of use Durable Binocular testing Results on site provided by the unit Non threatening to the child Usable from 6 months of age on Proven high level of reliable results

Screeners From Our Partners

Plusoptix S-12 Welch Allyn Spot

Administrative Details

FORMS:

Parental Consent to Screen

Pass/Refer notice

Screening Report

“Opt Out” check box for permission to follow up

STRUCTURE

District Childhood Screening Chairperson

Data Tracking and Reporting

Referrals -- Have a Plan!

MOTTO: Don’t start something you can’t finish Develop a referral system for your Club or District Partner with the eye care providers for examinations Partner with the surgical centers Partner with eyeglass providers Explore the state prison system for fabrication labs Consider recycled eyeglasses if legal but consider liability

issues

SUMMARY

Screen Children to find conditions we can help correct Be certain that you have a path parents can follow for

assistance if needed Attract new members through this amazing service

project – young members who have limited time Build a legacy

Easy To Get Started

3 MODELS TO CHOOSE FROM

Beginner – Getting Started

Club (or zone on a sharing basis) has a screening device

Club(s) has a HIPAA compliant system to screen children at places such as pre-k institutions, head-start programs, community health clinics and community organizations, health fairs, etc.

A HIPAA-compliant permission form parents need to sign with “Opt Out” follow up check box

A HIPAA-compliant document detailing screening results that the kids or organizations hosting the screening can share with parents or guardians

The ability to provide/fund follow-up exams and care for the medically indigent, or at least a list of resources/agencies that can help

Maintain a list of screening information including the number of children screened and percentage referred for an exam.

Intermediate – Take It To The Next Level

All the above Coordinate program at the district level or by a district foundation Network of eye care professionals supporting the program A coordinator, either a Lion volunteer or a paid staff person, to

schedule/coordinate screenings and support clubs with the program (parental permissions, referral and follow-up care coordination, etc.)

Pursue regional partnerships Maintain a central database of the number of children screened, referral

rates, and if possible outcome data of eye exams

Advanced – Go For The Gold Standard

All the above Coordinate program at the multiple district level and may have a

university or hospital partner with paid staff to coordinate program Pursue state-level partnerships with professional eye care bodies,

education associations, and seek state government funding or program collaborations

All USA Lions Clubs Screening All Kids6 Months to 6 years

LIONS MAKING A DIFFERENCE FOR THE NEXT GENERATION

Website:http://www.KidSightUSA.org