Sight The World: an innovative virtual, online vision clinic

Of the 2.2 billion people worldwide living with vision impairment, 50% are living with vision loss that can be avoided and treated if they had access to basic eye care services. Nine out of 10 of the world’s visually impaired people live in the developing countries, and 75% of all blind children live in Africa and Asia. An estimated 500,000 children become blind each year, but in developing countries up to 60% die within a year of becoming blind. Unless urgently addressed, the number of people experiencing vision loss will more than double by 2050.

It is estimated that as much as 80% of a child’s learning occurs through the eyes. Yet, access to equitable eye care remains a key challenge in many parts of the world. Those that are the most affected in this situation are school-going children, who are needlessly denied opportunities to excel in school due to visual impairment.

A simple eye exam can be transformative, but the scarcity of accessible vision care is crippling the most vulnerable populations, leaving them at an unfair socio-economic disadvantage. Children with vision impairment experience delayed motor, language, emotional and cognitive development, which can persist well into adulthood. Children who are in school but without access to vision correction have low levels of learning and educational attainment

Sight the World, EyeCare4Kids is working to make eye care accessible to children all over the globe.

Sight The World is a new extension of our eye care humanitarian program. EyeCare4Kids’ innovative virtual clinic will provide quality vision to low-income children and underserved families in the United States and globally. Using a standard website browser we will provide the whole gamut of professional vision care – pre-screening to determine the existence of a chronic problems, eye exams, evaluations by a qualified optometrist, and selecting and trying on eye glasses. By removing the logistical and financial burden of an office visit, we can reach anyone with a computer or a mobile phone anywhere in the world. We are also partnering with 1800Contacts to offer discounted or free prescription glasses or contact lens for those who need it.  We will have unique vision voucher codes built into our SightTheWorld.org website to give away glasses for free. Our existing and new community partnerships will help us identify and connect with patients who are in need of eye care services here in the US and globally.

Our target population is primarily the 500 million children worldwide without access to the most basic eye care services. The majority of vision impairment cases, especially in children, is due to refractive errors and can simply be corrected with a pair of eyeglasses.  In United States, between 30-50% of children in low-income, minority, rural and immigrant communities go without necessary professional eye care services.  Uninsured children are three times more likely to go without eyeglasses when needed.  With typical eye exam and glasses costing upwards of $250-$350, most children cannot afford critical sight correcting care.  In other parts of the world, most families face similar challenges. Due to scarce eye care health practitioners and prohibitive costs of existing services, many children in low-income countries needlessly go blind.  This virtual clinic is an effective and practical intervention that has a much broader reach than a brick and mortal or mobile clinic, and will have profound positive life-long impact.

Since its inception in 2001, EyeCare4Kids, a non-profit organization, has been serving 35,000 patients every year at our freestanding clinic in Midvale, Utah as well as 7 community, school-based and mobile clinics in Utah, Nevada, New Jersey and Arizona. An integral aspect of EyeCare4Kids’ mission is our international humanitarian trips to provide free eye care and specialized sight-restoring surgeries. Since 2013, our organization and team of volunteer ophthalmologists have provided treatment to over 7,000 children and adults in Laos, Rwanda, Cambodia, Peru, Guatemala, and Kenya. We have created lasting partnerships with local doctors and communities through these trips. The demand for our services both domestically and internationally continues to grow exponentially every year. Given the considerable financial and labor force cost needed to respond to these requests in a conventional manner, this virtual clinic is the logical and more feasible next step in scaling up and expanding our outreach. 

We are applying to Solve because we are interested in leveraging the experience and knowledge of similar organizations working in this field.  Our organization is interested in becoming part of a global network that we can learn from and partner with in our endeavor to sight the world.  A major challenge we face as a US based organization is making the virtual clinic accessible to global populations. Through Solve we hope to link up with potential partners in various countries to help navigate and address cultural, social, and technical barriers. 

A virtual clinic accessible to the global population at low or at no-cost will revolutionize the delivery of basic corrective vision care.  While the concept of tele-health is not new, our solution is innovative in two ways: 1) accessibility to the clinic is not limited by geographical location; and 2) our approach does not simply substitute a virtual call for an office visit, but instead provides the full range of services from consultation, diagnosis, treatment, to post-treatment follow-up in a manner that is cost-effective without sacrificing the quality of care. 

Our impact goal for the next year is to get the virtual clinic fully operational. EyeCare4Kid’s recently standalone clinic in Midvale, Utah will serve as the headquarters for the virtual clinic with qualified staff already in place.  Our recently expanded clinic includes an in-house lab with the expertise and capacity to produce prescription glasses and contact lens. We are also partnering with 1800Contacts on our inventory of glasses and contact lens. Our goal is to provide corrective vision services to a million children over the next five years.  

We aim to achieve SDG Goal 3 – good health and well-being- ensuring healthy lives and promote well-being for all at all ages.  Good vision is linked to increased quality of life and overall wellbeing including educational attainment, employability and financial security, independence, social belonging, self-esteem, stable mental and physical health. Poor eye health is driven by poverty and inequality. Key socioeconomic indicators including inclusive economic growth, employment and improved living standards are all linked to good eye health and vision.  In addition to addressing good health, our cost-effective outreach solution will likely also have positive outcomes for other SDG goals.

EyeCare4Kids measures its impact both in quantitative and qualitative terms.  We will track the tangible outcomes – site visits and orders, and number and types of eye care services delivered. Equally important is the impact of on our patients’ quality of life and overall wellbeing.  

Ninety percent of all visual impairment worldwide are preventable and can be treated if people had access to basic eye care services. Our virtual clinic is well positioned to provide simple and cost-effective vision correction solutions that will have immediate and life-long positive outcomes on a broader scale. There are tremendous benefits to individuals, families, and communities that result from investing in restoring and improving the sight of people globally. The World Health Organization estimates a $411 billion loss in productivity each year as a result of treatable vision impairment. A $1 investment in sight care and restoring services yields an average of $4 in economic gain. At an individual level, improved vision increases the quality of life and overall wellbeing.  

The International Agency for the Prevention Blindness (IAPB) asserts that eye health is essential for achieving most of the Sustainable Development Goals:

• End Poverty: Poverty is both a cause and consequence of poor eye health.

• End Hunger:  Improved vision can increase household income, which in turn reduces hunger.  For example, household incomes around the world increased by 46% for people who underwent free quality cataract surgery.

• Good health and wellbeing: Eye health is linked to good physical and mental wellbeing. Poor eye health increases the risk of mortality up to 2.6 times.    

• Quality Education: Good vision has a positive impact on school enrollment, educational attainment and learning. Eyeglasses can reduce the odds of failing a class by 44%.

• Gender Inequality: Women and girls are more likely to have vision loss and experience additional barriers to eye care services.

• Decent work and economic growth: Good eye health promotes inclusive economic growth, employment and improved living standards.  Providing glasses can increase work productivity by 22%. (IAPB, 2020)

The virtual clinic will utilize digital information and communication technologies, such as computers and mobile devices to provide remote access to essential eye care services. We will use a standard website browser to perform eye screening,  and vision exams and evaluations.

EyeCare4Kids is committed to ensuring diversity, equity, and inclusivity in the work place.  Out of the three founders of the organization, two are women. We primarily work with minority and immigrant communities, as a result our partners (teachers, parents, community leaders and health practitioners reflect this diversity.  At our clinics we employ various strategies to continue to promote diversity, equity, and inclusion; training, acknowledging and addressing biases, giving employees a voice, and creating opportunities.

Our business model can be described as a hybrid free-for-service and low-income client. Sight the World is virtual online clinic designed to provide quality vision care services to low-income children and underserved families in the United States and globally. Using a standard website browser we will provide the whole gamut of professional vision care – pre-screening to determine the existence of a chronic problems, eye exams, and evaluations by a qualified optometrist. Patients can also select, try on and purchase eye glasses made to their prescription needs. The products will be distributed through our existing network of partners or through the mail. 

Our beneficiaries are the 500 million children worldwide without access to the most basic eye care services. The majority of vision impairment cases, especially in children, is due to refractive errors and can simply be corrected with a pair of eyeglasses.  Our strategy for reaching new patients is through the website as well as our networks of partners, which include schools, clinics and hospitals, both here in the US and around the world.  1800contacts.com is a stakeholder in this endeavor as they are providing our inventory of glasses and contact lens. The prescription eyeglasses are produced at our in-house lab for a nominal cost. 

We have partnered with 1800contacts.com for eye glasses and contact lens inventory for our Sight the World initiative.  EyeCare4Kids has an in-house lab that has the capacity and expertise to produce quality prescription eye glasses at a very low cost.  Other revenue sources include: 1) sale of eye glasses and contact lens at discounted prices to customers to offset the cost of providing these products for free to low-income patients; 2) providing opportunities to anyone who visits our site to sponsor eye glasses for a child for $35; 3) individual donations, corporate gifts, and grants; and 4) accepting medicaid to cover the cost of services and products for qualified patients.  

We are still in the pilot phase of our project, but we already have an inventory of 1 million eyeglasses that we will be distributing to patients at no cost.  We have raised funds from private donors to upgrade the equipment and technology in our standalone clinic which will house the online virtual clinic.