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WE’VE ALL HEARD the stats; 80% of the learning a child does is through their eyes. Myopia is on the rise! The percentage of children in the U.S. estimated to need glasses is somewhere between 40-45% and growing fast… And yet, less than 15% of pre-school children receive an eye exam by a professional. If children are our future, they’re in for a really blurry ride.

In theory, school nurses are meant to catch the children with vision issues through regular grade school screenings. In actuality — even before COVID — many school nurses were underfunded, underequipped and undertrained to be effective at catching many visual deficits. In a post-COVID world, matters have just gotten worse.

According to the AOA, up to 75% of school screenings miss vision problems, and 61% of children found to have eye problems through screenings never visit a doctor. But we’re well-educated, rational adults, we can solve this problem … in fact, we spoke to several ECPs who have already figured it out.

School nurses actually make great community partners and can be a fantastic funnel of kids into your practice, not to mention the good will and name recognition having boots on the ground in your local schools provides.

“This is a topic that has literally built our business for the past nine years,” says Dr. Katherine Schuetz of Little Eyes in Carmel, IN. “Between referrals from pediatricians and school nurses, we’ve gone from just me solo two days a week to five days with two docs most afternoons.”

Schuetz and her team have been volunteering for school screenings since 2010. “When my schedule was light those early years, it was a great way to serve our community and build our patient base offering our time doing vision screenings,” she says. “I started with one school, and the school nurse found our process to be so much more pleasant and efficient than the past, that she gave our name to all the district nurses. Word spread and now we typically do around 15 schools every year.”


Dr. Cathy Doty of SpecialEYES in New Bern, NC, has been working with nurses the entire span of her career. “Approximately 30 years, however, over the past seven, I have been exclusively working in our SpecialEYES clinic with pediatric and special needs patients. Therefore, my relationship with our school nurses has naturally strengthened,” she shares.

And school nurses can use all the help they can get. They are supported by general education funding, which means all those stories you hear about school funding being cut and education budgets getting gutted often directly affect the nursing staff in primary schools.

“Our school nurses work full-time for part-time pay in most cases,” says Doty. “They are not one-to-one with a school. Several schools may share a nurse. This is one area where our public school budgets fall short.”

“I’ve had meetings with my OD and school nurses. The nurses get zero training and don’t screen well,” adds Carissa Dunphy of Monroe Vision Clinic in Monroe, WA. “They also have no resources to get help. My office bought vision screening and low vision kits and donated them to our district. They were super appreciative and felt like they were doing more good.”

“In the earlier years, I dropped off glasses repair kits and contact lens solutions/cases to nurses,” explains Schuetz. “I also let them know if they had an eye-related emergency, we are always happy to see patients same day. Nurses are often put on the spot to diagnose a red eye or handle an injury, and they were grateful to know we could help so students miss minimal school time or avoid a trip to the ER. We make sure they have our basic office info, a few brochures, and two exam vouchers for every nurse so that if there’s a student that has visual need as well as financial hardship, we can be of help.”

In Holland, MI, Beth Cassar of Complete Eye Health and Contact Lens Center has reached out to local school nurses and hand-delivered eyecare kits featuring a small screwdriver, miniature screws, cleaners, cases and contact lens solution to help them troubleshoot minor problems. This has helped Complete Eye Health build sturdy relationships with the nurses, whom Cassar calls key influencers in their communities. The nurses will often send kids to the shop who are in significant need and, in some cases, have even called to make their appointments.

“As I transitioned into my role at SpecialEYES, I wrote letters to each school nurse and gave them my cell number and business card,” states Doty. “Every August, we create ‘goody bags’ for each school nurse containing artificial tears, contact lens cases, multi-purpose solution, glasses cleaners, bottles of ophthalmic saline, cleaning cloths, office pens, and business cards. I also write a letter and sign each one, thanking them for all they do.

“Pre-Covid, we dedicated Monday mornings — September through May — to visiting each school in our district to repair/adjust glasses for students and staff. We took three staff members, optical tools, frame parts, heat pans, and treats. Each school nurse signed up their school for our Monday schedule. We visited every elementary, middle, and high school in our district during the school year. If a student had damaged glasses, or lenses scratched beyond use, we recommended replacement. If their insurance was unable to assist them, then we could always count on the Essilor Vision Foundation to provide glasses free of charge. We hope our office will be able to provide this service again this fall.”

Dr. Doty raises a good point: If you’re interested in establishing or strengthening your relationship with your local school district, you don’t have to go it alone. Use the resources available to you. “Doing a screening is very time consuming if you do the subjective testing yourself; unnecessary and inefficient! Reach out to the Lions Club or other similar organizations to ask for help,” says Schuetz. “The nurses don’t have time for visual acuities and stereopsis testing but neither do you. Also, be generous with repair kits for glasses and contact lens supplies. These are things that nurses aren’t provided and they’re often needed.”


While not all children in need of vision care are also in financial need, the two do often go hand in hand. Do a little research on the demographics and likely major insurance plans in your districts and plan accordingly. “Many kids who need glasses do have state insurance but, for some reason, do not utilize it,” shares Dunphy. “Prior to utilizing a free care program it needs to be verified that the patient does not, in fact, have state insurance. Our office uses Lions Club for the exam, our lab donates lenses and we use a cause frame company and bargain frame lines in combination for the frames. It’s good to have options because not every frame will work for the majority of the people.”

Lambaria Eye & Optical in Davison, MI, meanwhile, connects with counselors at nine area schools and provides each 10 vouchers for a free eye exam and free glasses. Counselors can then distribute the vouchers to students with vision needs, particularly those without the means to purchase glasses.

“Teachers need all the help they can get in the classroom,” states Doty. “We can support educators by taking the vision piece off their plate. If children can see well, research confirms that they will perform better, behave better, and use fewer outside resources. Contact the director of your district’s school nurses and deliver lunch during their next group meeting. Give them your cell phone number. Return calls or emails. Be available.”

“Many of the kids who come in for routine exams recognize us from the screening or the result card we send home. We wanted to do good things for our community and it has evolved into helping our business,” concludes Schuetz.


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