Vision Screening by Alaska Blind Child Discovery

Alaska Blind Child Discovery

Case Study for the University of Alaska Anchorage by Licensed Optician and OAA Firm Member Beverly J. Harper

Healthy human beings are born with multiple senses, from sight, and sound, to touch, taste, and smell. Each of these senses has a purpose, and each keeps us safe, adding important attributes to our life. But what if we lost one of those senses? What if that sense was vision? Vision is a key sense used in the process of learning. Without vision, learning becomes impaired. Let’s agree for now that vision is the sense we rely on the most. Should reasonable efforts be made to preserve this valued sense?

A bright eyed eleven-year old girl entered my office recently; she had just received her first comprehensive eye exam. Her parents weren’t poor, they were not negligent. She had always had proper medical care, but something was missed. The exam unfortunately revealed permanent vision loss in her right eye. This vision loss was due to amblyopia, a completely correctable disorder sometimes referred to as “lazy eye”. This is often a genetic condition.

Amblyopia is reduced vision, caused when the brain ignores one eye, often due to development problems with the visual system. Sometimes the eyes appear normal, and sometimes one or both eyes turn in or out. Early testing can diagnose amblyopia, and early treatment can correct it.

Imagine tying one arm behind your back for seven years, and then untying it, how useful would that arm be? Physical therapy would be necessary, just as glasses are necessary for amblyopia. It is however, imperative that treatment occur before the age of seven. It is too late for this young girl. Her visual system is fully developed; no correction will change her visual acuity. This is not an isolated case. Not a week goes by that I and others in the eye care field don’t witness a child with late diagnosis of amblyopia. Multiply that by the thirty odd years I have been an optician, working with pediatric ophthalmologist’s, and the numbers reach into the thousands, and that is just whom I have encountered.

According to the American Board of Ophthalmology 3-5% of children have amblyopia. Studies indicate the standard Titmus eye chart, used by most pediatricians, has 9%-13% sensitivity to amblyopia. However, visual photo screening performed by either the Photo screener or the Visiscreen 100, a specially designed hand held camera, has 75%-85% sensitivity. They are certainly more expensive than an eye chart, about $200 for the camera; however, they are simple to use and last for years.

Few states mandate or even recommend photo vision screenings for pre-school children, yet they effectively and quickly detect visual problems including amblyopia. American Board of Optometry states 25% of school age children have visual problems, half undiagnosed, and many of those have amblyopia. U.S. Senator Christopher Bond of Missouri sponsored Senate bill S1117 in 2007 called “Vision Care for Kids Act”. Senator Bond is blind in one eye, due to undiagnosed amblyopia. He is clear about the importance of vision screening when he says “good vision is critical to learning”.

The state of Tennessee is now implementing photo visual screening with the assistance of their local The Lions Club, the organization renowned for their mission of saving vision. They have paired up with a state university and opticians in their state. Alaska Blind Child Discovery (ABCD) has a similar mission.

The Lions Club, along with ABCD, has sponsored some vision screening clinics in Alaska but without consistency. Two main problems were often present; the first ,cost of the needed cameras and evaluation, and the second, locating screeners that had access to pre-school children.

Massive screenings are expensive, but both the Lions Club and ABCD have plan and desire to meet this need. Currently some cameras have been purchased and donated by Lions Club to a few local pediatricians whom perform the screenings. All photos can be reviewed by the pediatric nursing staff and referred to pediatric ophthalmologists. With the purchase of more cameras and financial support to offset such costs, this program could expand.

With the backing and recommendations of pediatricians along with other health care providers, photo vision screening could make a difference. Parents are accustomed to various types of screenings. A protocol of photo visual screening could be incorporated along with standard mandates upon entering kindergarten. Screenings could be offered at health fairs, malls, day cares, and other health provider locations. However, the most logical location would be the community pediatrician’s office. Public education is needed. Parents need to be made aware of this often overlooked condition.

The current and pressing need is funding to support the growth of vision screening. Currently such screening, although recognized by Medicaid, Denali Kid, and other health insurance plans, is not a covered service. There is a legislative movement to correct this, but as we know that process can be very slow. The financial support of ABCD and vision screening for all Alaskan pre-school children needs to occur now. Children need diagnosed before it is too late. The net result would be saving vision. Children could see the world.

History of ABCD

Dr. Robert Arnold, an investigator in the Pediatric Eye Disease Investigator Group, and pediatric ophthalmologist at Ophthalmic Associates in Anchorage, Alaska, formed Alaska Blind Child Discovery in 1998. The mission was established and a joint venture began with the local Spenard Lions Club. Early screenings began in bush Alaska, including such villages as Koyukon, Bethel, and other rural areas of Alaska.

Dr. Arnold was soon joined by volunteers and lumineers: Diane Armitage, Connie Arnold, Dr. Howard Freedman, Dr. Arnall Patz, Jack Bellows, Dr. Sean Donahue, Dr. Kurt Simons, Dr. Alex Kemper, Sue Cotter, O.D., Dr. Robert Hered, and Velma Dobson, Ph.D. The current board members of ABCD include: Robert Arnold, M.D., Daniel Tulip, M.D., Diane Armitage, and Connie Arnold. Each of these professionals contributes their expertise in the area of childhood blindness and the prevention of such disorders.

Mission Statement

Alaska Blind Child Discovery is a charitable non-profit organization committed to providing vision screenings for the purpose of reducing and eliminating childhood blindness ,due to amblyopia, and other visual impairments for Alaskan children.

ABCD will foster vision screening, care, and research with the goal of preventing, restoring, and improving visual impairments of children in Alaska.

Resource Development Plan

The current goal of ABCD is to raise funds to provide vision screening for all Alaskan pre-school children through the year 2014. It is predicted that legislation mandating such screening coverage by Medicaid/ Denali Kid, and health insurance will be available by 2014.

U.S. statistics states 7.6% of Alaskans are under the age of five. This number translates into approximately 50,000 children. Fifteen dollars per child would meet the financial need in Alaska, covering the cost of visual screening. With a financial goal of $750,000, each and every child under the age of five could receive a vision screening within three years.

In order to raise this amount of money the fundraising must take place over a three year time period. The goal of $250,000 per year is a more reasonable and achievable goal. It will be necessary to contact all specialists currently practicing in the field of eye care. The contact must take place both through letter mailings and personal communication.

The cost of mailings, including printing and postage will total approximately $1,000. Other mechanisms of contact will include phone calls to business acquaintances, and personal visits will also have costs, including possible travel to outlying areas. Total budgeted expense is expected to reach $5,000. Acknowledgement of volunteers and donors must also be considered.

The current donor list consists of a few ophthalmologists, one ophthalmology medical practice, and a small number of ophthalmology researchers. It is likely this list of possible donors could be expanded greatly. There are approximately twenty-four ophthalmologists in Alaska, fifteen practicing in Anchorage. In addition to physicians practicing eye care, there are also over seventy-five optometrists along with about 100 licensed opticians. It is also necessary to include the over 100 pediatricians practicing in the state of Alaska. Each group listed has a vested interest in the mission of ABCD. As eye care providers, or pediatricians, the visual health of children is an important part of their profession. Each of these specialists typically is a member of their local professional association. Accurate lists can be obtained from the State of Alaska Department of Occupational Licensing.

According to the American Optometric Association optometrists habitually donate to various activities their association sponsors. The American Academy of Ophthalmology and American Academy of Pediatrics are each dedicated to the visual health and well-being of children. This value meets the mission of ABCD. These associations often allow non-profit fundraising announcements in their newsletters that reach all members.

The current board members each have relationships, both personal and professional, that would be very beneficial to reaching the sought after donors. Connie Arnold has worked with other past boards and committees raising money for missionary work in Burma. This experience will be very helpful in the development process.

Alaska Blind Child Discovery will foster vision care and research with the goal of preventing, restoring, and improving visual impairments of children in Alaska. This includes providing vision screenings for the purpose of reducing and eliminating childhood blindness due to amblyopia and other visual impairments for Alaskan children.

The mission statement adequately addresses the goals of ABCD and the use of any funds ABCD acquires. The current board members will be sufficient as fundraisers for ABCD. Currently the organization is very small and focused on one mission. Each of the board members brings unique talents and relationships that will be of great assistance in the fund raising process. Networking will be crucial to meeting the financial requirements of the mission. Each board member will be charged with an individualized donor list along with financial goals.

The next three fiscal years ABCD is going to require $260,000 each year in order to cover expenses and fund the vision screening project. The goal is to screen at least 16,000 pre-school children each year. The money raised will help offset the cost of vision screening to be held in each village clinic and/or pediatric office. The clinics are donating its staff time, but costs are incurred with the camera and analyzing the results. It is a three year plan, with hopes that Medicaid, Denali Kid, and other health insurance will soon reimburse for the service.

The board has agreed that expenses for fundraising will not exceed $10,000 per year. It also agrees that all amounts over the expense of fundraising will be spent on vision screening.

Since the organization is going to rely heavily on person-to-person major gift initiative, establishing the goal potential will be based on the board of director’s contributions. The board will contribute 15 percent of the annual financial goal. The yearly funding need is $260,000. With this need the board must contribute $39,000 each year in order to help meet the goal. Using this calculation it is expected that $221,000 will come from outside donors. Whether this is feasible depends on many factors, none as important as the “ask”. It is predicted that since many of these potential donors are new prospects the probability of received donors may be around 20-30 percent. Keeping this calculation in mind each potential donor, approximately 200 of them, must be asked to donate $5,000. In some cases it may be more productive to approach medical practices and ask for corporation sponsorship. Keeping the amount of $5,000 per potential donor in mind when approaching a medical practice, it would be beneficial to multiply the number of practitioners in the group by $5,000 to determine the appropriate amount for a group donation.

The proposed budget for the development plan includes both the projected income and expenditures.

Sample Budget

Income

Personal Solicitation

Board Campaign Contributions (4 members 2@ 15K; 1@ 5.5K, 1@ 3.5K. $39,000
Individuals $120,000
Corporations $101,000
Total Contributed Income $260,000

Expenses

Relationship-Nurturing Activities

General Postage 110
Printing 800
Travel, Food, Lodging 2000
Informative Gatherings 700
Volunteer and Donor Acknowledgment 3000
Total Expenses $6,610
Net Contributed Income $253,390

With a three year life span of this particular fund raising project it has been determined that the fundraising will be done on a yearly basis. The efforts will begin in October of each year, with the anticipation of reaching each donor prior to budgeting for their upcoming fiscal or the calendar year. The funds must be received within ninety days of the solicitation.

The initial form of contact will begin in the professional association newsletters. This is an excellent method to initially announce the upcoming campaign. This will be followed by individual personal mailings, reminding the donor of the great need for vision screening. Personal contacts will be the final approach. Meetings will be set by each board member to meet with the groups or individuals in their charge. Whenever a corporation is approached at least two board members will attend the meeting.

The following dates will mark duties to be performed and deadlines to be met.

October 4, 2010

Send formal letters to the following association newsletters for announcements: American Academy of Ophthalmology, American Optometric Association, American Academy of Pediatrics, and Opticians Association of America.

October 6, 2010

Each board member will call potential donors and schedule meetings. Scheduling goal for meetings will be end of October. Dr. Arnold will call potential medical practices. Dr. Tulip will contact pediatric offices. Connie Arnold will call independent and individual optometrists and physicians, and Diane Armitage will call local opticians and their association board members.

October 20, 2010

Board will meet and review status of upcoming meetings and donation pledges.

October 23-31, 2010

Meeting week. All board members will be available for meetings both individual and group with potential donors.

November 1, 2010

Thank you cards must be sent to all contacts made, thanking them for their time and other appropriate or noteworthy statements.

November 3-8, 2010

Make follow-up calls to all contacts.

November 12, 2010

Board meeting to review status of fundraising. Document all collected donations, and pending donations. Make special note of dates of expected receipt of funds from donors. Send thank you letters to all donors of date.

November 25, 2010

Thanksgiving

November 29, 2010

Black Monday. Call potential and expected donors.

December 1-18, 2010

Attend social gatherings for potential donors.

January 2-31, 2011

Final collection of pledged donations, and thank you letters

March 15, 2011

Appreciation Dinner and awards for donors and volunteers

Summary of Fundraising Strategy

Individual Supporters

Board members 2@ $15,000/each, 1@ $5,500, 1@ $3,500. $39,000
Large contributors 20 @$5,000/ each $100,000
Other forms of individual support: donated plaques $200

Institutional Supporters

Corporations & businesses $135,000
Religious institutions $3,000
Associations of Individuals $500

Appreciation Dinner Expense

Dinner 118 attendees @ $22/each $2,596

The development efforts surpassed the established goal for the year of 2011. The collected amount totaled $277,500 in cash donations and $200 in kind donations. Expenditures were slightly lower than budgeted. The net amount collected allows $271,494 to be spent on vision screening of 18,099 children. This will make a significant impact on saving the vision of possibly over 700 children suffering from amblyopia.

References

Alaska Blind Child Discovery (2009). ABCD inception. Retrieved July 1, 2010, from http://www.abcd-vision.org/

American Academy of Ophthalmology (2010, March). Amblyopia. Retrieved July 6, 2010, from http://www.aao.org/eyesmart/disease/amblyopia.cfm

American Academy of Pediatrics (2008, August 1). Use of photoscreening for children’s vision

Screening. [Electronic version]. American Academy of Pediatrics, 109, 3, 524-525.

American Board of Ophthalmology. http://www.abop.org/pdfs/m3-AMBpdf.July2008

American Optometric Association (2008). Amblyopia and children. Retrieved July 6, 2010, from http://.aoa.org/x7307.xml

Armitage, D. (personal communication, June 28, 2010).

Arnold, R. (personal communication, June 29, 2010).

Bond, C. (2007). Vision care for kids act. Retrieved July 6, 2010, from http://www.preventblindness.org/news

International Lions Club (1999). Pre-school vision screening. Retrieved July 6, 2010, from http://www.lionsclub.org/.../our-programs/sightfirst/initiatives/preschool-vision-screening

U.S. Bureau of Statistics. http://factfinder.census.gov/server/ACSSAFFFacts