Alabama has tens of thousands of low-income children who are uninsured and do not see a doctor regularly. As a result, many health conditions that can be detected and corrected at an early age, such as vision problems, are left untreated with devastating consequences. “Four years ago, there was not a state that comprehensively screened for children’s vision problems before public school,” says local attorney Stephen Black. In 2004, he formed FocusFirst, a non-profit program that uses volunteer college students to conduct free vision screenings throughout Alabama for children between the ages of six months to five years. 

 

Board member and Birmingham ophthalmologist Virginia Lolley, MD says, “Children with poor vision do not learn well because they can’t see. There’s a big difference in screening a two or three year old and a six or seven year old. We can almost always correct vision problems in a two or three year old so they regain functional vision. In some older children, the visual pathways are formed with the problem and there’s nothing we can do about it.”

 

Black, director of the Center for Ethics and Social Responsibility at the University of Alabama and the grandson of the late US Supreme Court Justice Hugo Black, started FocusFirst as a signature initiative of Impact Alabama to respond to the undiagnosed vision problems of children living in poverty. He says, “Regardless of your political affiliation, we, as a moral society, can do a better job of taking care of the needs of a poor three-year-old.”

 

Wykisha Brundidge’s son, William, had just turned two when she took him to a health fair near her home in Midfield. “We noticed that he fell down a lot and ran into the same things over and over again,” she says. “I know all kids fall down, but he seemed to do it more than other kids.” William was diagnosed with astigmatism and cataracts and was referred to Alabama Ophthalmology Associates for follow-up. Now age three, he intermittently wears a patch over his stronger eye to force his weaker eye to become stronger, and his vision should be improved by the time he begins school.

 

According to Impact Alabama, undiagnosed poor vision negatively impacts a child’s development by manifesting itself in behavioral problems, low academic performance, low self-esteem and a substandard education. Since 2004, more than 950 volunteers from twenty colleges and universities throughout Alabama have screened more than 35,000 children in all 67 counties across the state. Sight Savers of Alabama provides subsidized follow-up care for the approximately 12.4 percent who fail the screenings. Prior to FocusFirst’s inception, most vision screenings were conducted on school-age children and only 21 percent of preschoolers.

 

While working in the governor’s office in 2000, Black became fascinated with creatively improving the lives of Alabama’s citizens through the use of public policy. “I noticed young people were starting to act charitably, more so than in recent years, but they were not very well organized,” he says. “I am intrigued with the idea of social justice providing ordinary people the opportunity to do extraordinary things, and I am in awe of the willingness of this young generation to make a difference.” In 2004, to provide a way for young adults to contribute to direct service in their communities, he founded Impact Alabama: A Student Service Initiative.

 

Students from selected fields of study volunteer with FocusFirst to conduct vision screenings at HeadStarts and lower-income daycare centers within driving distance of their college. They are trained to use specialized portable photo optic scan cameras, a technology that was originally developed for use by NASA. Vision Research Corporation (VRC) manufactures the cameras that use photorefractive technology to take highly detailed photos of the children’s eyes that can later be analyzed for a wide range of problems. VRC also provides training, technical assistance and maintenance for the cameras, as well as analyses of the materials and delivery of the results.

 

FocusFirst started with three staff members and a handful of volunteers. For the 2008-2009 academic year, FocusFirst employs 11 full-time and 8 part-time staff members across the state to coordinate volunteers, screenings and follow-up. Black says, “We employ talented, socially conscious recent college graduates for one or two years following graduation to oversee the implementation of our initiatives in return for a stipend and a small scholarship toward post-graduate work.” According to the website, the goal for this year is to increase by 50 percent the number of daycare centers reached and to screen more than 16,000 children in every county. If the 12.4 percent failure rate holds, almost 2,000 more Alabama preschoolers will be helped before their vision is irreparably set.