1. Children’s Vision Screening
Lions Clubs International
Children’s Vision Screening
Development of a Lions KidSight USA Program

2. 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

3. 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.

4. 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.

5. 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.

6. 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.

7. 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.

8. 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

9. Effects of Poor Vision In The Young
Poor literacy
Behavioral Disorders
No participation in sports
Poor socialization
Other social/behavioral issues

10. 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

11. 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

12. When Should We Screen Where 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.

13. 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

14. Screeners From Our Partners
Plusoptix S-12
Welch Allyn Spot

15. 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

16. 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

17. 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

18. Easy To Get Started
3 Models To Choose From

19. 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.

20. 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

21. 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

22. All USA Lions Clubs Screening All Kids 6 Months to 6 years
Website:
Lions Making A Difference for the next generation