UA students play a key role in making Alabama the top state in the nation for finding and correcting vision problems in young children.

By:    Date: 12-03-2016

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Preschooler Jaden Knox didn’t say a word during his vision screening at Central Elementary School in Tuscaloosa. “He seemed both scared and extremely shy,” recalls University of Alabama student Melanie Chwalek, who conducted Jaden’s screening in September 2015 as part of The University of Alabama’s FocusFirst service-learning initiative.

Jaden failed the screening, and a few weeks later Chwalek, a senior majoring in psychology who will begin optometry school in Fall 2016, saw him again at Tuscaloosa EyeCare, where she works as a doctor/patient assistant.

“He was still very quiet at the beginning of his appointment,” Chwalek says. “However, by the time we adjusted the phoropter, the instrument eye doctors use to correct vision problems, a bright smile came over his face as he excitedly told his mom over and over that he could see everything and he didn’t even know there were letters on the screen before. He would not stop talking and naming everything he could see in the room with his new prescription.”

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Vision screenings are conducted using photo-optic cameras.

Vision problems in young children are more common than most people realize. Each year, poor eyesight adversely affects millions of children under age 6 across the United States, due largely to lack of public awareness about the importance of eye care in young children and the inability of children to recognize their own vision impairment. While vision screenings are most effective during the preschool years, when early treatment of many conditions can prevent irreversible vision damage or loss, only 21 percent of preschool children nationwide receive comprehensive vision screenings.

Thanks to FocusFirst, an initiative of the UA Center for Ethics & Social Responsibility, Alabama leads the nation in diagnosing and addressing vision problems in young children. College students provide free, high-tech vision screenings to children across the state, detecting vision problems in approximately 11 percent of those screened.

Many college-student volunteers receive academic credit for their work with FocusFirst through service-learning courses. “There are two sides to FocusFirst,” says Stephen Black, director of the UA Center for Ethics & Social Responsibility and founder of FocusFirst. “We wanted to figure out a way to make a positive impact on the community and also get college students involved. Many students take for granted the ability to see a doctor regularly.”

As part of a statewide, campus-based effort, undergraduate and graduate students ensure children ages 6 months to 5 years in pre-kindergarten programs and daycares are screened for vision problems. FocusFirst partner Sight Savers America, a nonprofit dedicated to improving eye care among children, provides free follow-up care to those with potential vision problems.

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High-tech photos reveal vision impairments that usually go unnoticed in young children.

Since the launch of FocusFirst in November 2004, more than 3,200 student volunteers have screened more than 300,000 children in all 67 counties across Alabama. FocusFirst regularly works with 10 colleges, and UA leads and coordinates the statewide screening efforts. Since 2004, more than 1,000 UA students have participated with FocusFirst, screening approximately 22,249 children in 14 counties. Seventy-four UA students participated in screenings across four counties during the 2015-16 academic year, reaching more than 1,600 children.

“Vision is indescribably important,” says Anna Marie Symmonds, a freshman majoring in biology and aspiring optometrist who began volunteering with FocusFirst in Fall 2015. She screened pre-K students during health fairs at their schools. “From talking to many of the children, they had never had their vision screened,” she says. “Their lack of screening really changed my outlook on how helpful initiatives like FocusFirst are.”

Left untreated, poor vision can have negative consequences on children’s educational performance, self-esteem and behavior.

Summer Moore, whose 4-year-old daughter, Bella, was diagnosed with anisometropia, a condition in which one eye has much poorer vision than the other, during a FocusFirst screening, says her daughter would have had serious problems learning to read if her vision had not been corrected. “My first reaction was devastation; how could I not have known?” Moore says. “The doctor told us that if we hadn’t caught this by age 6, she would have gone blind in one eye.”

Moore says she noticed Bella didn’t like books and coloring sheets, but didn’t know that could be a sign of poor vision. “Since getting glasses, Bella loves to sit down and read and color,” Moore says. “If it wasn’t for FocusFirst, I would have never known she had a problem.”

Even if a problem is detected, correcting it can be a challenge for families suffering from financial hardship and lack of access to medical care. “My first thought was I can’t get him an appointment because I don’t have insurance,” says Erin Hughen, whose son Cayden was diagnosed with a congenital cataract. “SightSavers has helped a lot instead of having to pay out of pocket.”

Chwalek says knowing her service helps parents rest easier has given her a sense of humility and purpose. She says college students often forget how fortunate they are to be in good health and getting a great education. Because financial constraints would prevent many of the children FocusFirst serves from seeing an eye doctor, she says the initiative made her aware of the realities other people in her community face. Chwalek, who is president of UA’s Pre-Optometry Society, has volunteered with FocusFirst for more than two years and has motivated other students to get involved.

“My classes have given me the background to understand the science of what is causing these kids to have the eye problems that they do, while FocusFirst has provided me with the feeling of reward that comes when you give back to the community,” she says. “I will be checking vision and eye health for the rest of my life, and FocusFirst has reassured me that this is the correct career path for me.”

FocusFirst is a signature initiative of the Center for Ethics & Social Responsibility and Impact America, a nonprofit housed at The University of Alabama that collaborates with 30 colleges and universities in four states to implement service-learning projects that engage students in addressing human and community needs while enhancing their sense of social and civic responsibility.

To learn more about FocusFirst, visit