DELANO, Calif. 鈥 Daisy Leon struggles to sit still and read the letters on the eye chart. Her responses tumble out in a quiet, confused garble.
鈥淵ou know your letters?鈥 asks optometrist Jolly Mamauag-Camat. 鈥淯mm, ya,鈥 says Daisy, almost inaudibly.
The 6-year-old kindergartner had her eyes examined for the first time on a recent Thursday morning. Although she hadn鈥檛 complained about headaches or blurry vision, her grandmother noticed she鈥檇 been inching closer to watch television.
After Daisy鈥檚 failed attempts at reading the eye chart, Mamauag-Camat inspects the little girl鈥檚 eyes through a phoropter and writes her a prescription for glasses.
At least of school-age children in the U.S. have vision problems. But according to the , fewer than 15% of children get an eye exam before entering kindergarten. Because vision problems tend to worsen the longer they go undetected, many children suffer even though there are often simple, relatively inexpensive solutions such as prescription glasses.
plus the District of Columbia require screenings or exams for preschoolers, according to the National Center for Children鈥檚 Vision & Eye Health. But California has no such requirement, said , an assistant professor of research ophthalmology at . California does require them for older children.
鈥淭he system in California is not as good as it can be,鈥 Jiang said.
In much of California鈥檚 Central Valley, where roughly people live in poverty, two school districts are working with two nonprofits, the and , to provide vision care to Kern County鈥檚 underserved and uninsured children.
Many of the neediest are the children of farmworkers.
鈥淲e are an agriculture-based community,鈥 said Linda Hinojosa, coordinator of health services for the Delano Union School District. 鈥淢ost of our families harvest table grapes 12 hours a day, with very limited time to take their children in for an eye exam.鈥
The program, funded by the nonprofits and the school districts, operates five school-based clinics in Bakersfield and Delano. Students receive comprehensive eye exams and glasses, along with free transportation. And breakfast.
Most of the children who visit the clinics have coverage through Medi-Cal, California鈥檚 Medicaid program for low-income people. There is no out-of-pocket cost for the eye exams and glasses for them, or for children who are uninsured, said Alexander Zahn, chief business development officer for the Advanced Center for Eyecare.
Almost examined need glasses.
鈥淭he need was very apparent鈥 in the Central Valley, Zahn said. 鈥淪ixty dollars for an eye exam and $80 for glasses might be the difference between eating dinner a couple days a week.鈥
Daisy was among 12 students who were bused to the Delano Union School District Vision Center, adjacent to , an elementary school with about 1,000 students. Almost all the students at Pioneer are Hispanic and about qualify for free or reduced-price lunches.
Students from throughout the Delano Union School District visit the clinic. Since it opened in 2018, the clinic has performed 961 eye exams and prescribed 517 pairs of glasses.
For Daisy, whose parents are farmworkers, the clinic has been a tremendous help.
鈥淭hey prune out in the fields,鈥 said Guadalupe Leon, Daisy鈥檚 grandmother. 鈥淭hey can鈥檛 afford to take days off.鈥
The Delano Union School District Vision Center is funded by multiple sources: OneSight, a nonprofit organization dedicated to increasing access to vision care in underserved communities around the world, donated the ophthalmic equipment and provided grant funding for the first year of operation. The Advanced Center for Eyecare provides staff and supplies. And the school district provides the facility, furnishings and transportation. (Heidi de Marco/KHN)
Twelve students from Nueva Vista Language Academy and Fremont Elementary School arrive by bus for their eye exams and follow-ups. Linda Hinojosa, a registered nurse for 20 years, says lack of transportation is a major barrier to vision care. 鈥淧arents a lot of times don鈥檛 have a car, or it can be a one-vehicle family,鈥 she says. (Heidi de Marco/KHN)
Students are offered breakfast before their appointments with optometrist Jolly Mamauag-Camat. About three-quarters of students in the district are eligible for free/reduced-price meals. (Heidi de Marco/KHN)
Daisy Leon, a kindergartner at Nueva Vista Language Academy, takes a test to check for color blindness. Before beginning, the optical technician asks Daisy if she understands English. Because of the region鈥檚 large Spanish-speaking population, clinic staff members often act as interpreters. (Heidi de Marco/KHN)
Daisy looks into an auto refractor as part of her eye exam. (Heidi de Marco/KHN)
Daisy and Jonathon Castro watch a movie as they wait for their eyes to dilate. This is the first eye exam for both of them. (Heidi de Marco/KHN)
Daisy sits on her knees to see through a phoropter, a device to help determine eyeglass prescriptions. Mamauag-Camat says children often can鈥檛 tell if they have vision problems because they don鈥檛 know any differently. 鈥淭hey can fall through the cracks,鈥 she says. “They don鈥檛 know the difference between what鈥檚 clear and not clear.鈥 (Heidi de Marco/KHN)
About 45% of Kern County鈥檚 population is on Medi-Cal. Medi-Cal covers vision care, including an eye exam and glasses every two years, but in communities like Delano, access is a problem. 鈥淲e live in an area with a big shortage of providers, particularly specialty care providers like optometrists and ophthalmologists,鈥 says Alexander Zahn, of the Advanced Center for Eyecare. (Heidi de Marco/KHN)
Daisy picks out glasses right after her exam, a pink pair that she had been admiring all morning. 鈥淲e need to go where students are,鈥 says Hinojosa. 鈥淰ision is absolutely vital.鈥 (Heidi de Marco/KHN)
This story was produced by聽, which publishes聽, an editorially independent service of the聽.
