See By Three™

The Children's Eye Foundation's See by Three program is a three-point program aimed at significantly reducing amblyopia in young children by the year 2020.

The design, implementation and evaluation of a standard vision screening and treatment program to be replicated nationwide
Developing and distributing an informational program dedicated to educating health professionals, including pediatricians, family physicians and school nurses, about amblyopia and other ocular diseases
A public awareness campaign to explain amblyopia and stress the importance of vision screening in preschoolers

West Virginia University Vision Initiative for Children (VIC)

Geoffrey Bradford, M.D., pediatric ophthalmologist, is the chief investigator for the West Virginia University Vision Initiative for Children (VIC). It is Bradford's plan to properly train, equip and support 120 (52 percent) of the state's licensed pediatricians on the most effective way to perform vision screening for children between the ages of three and five.

Nemours Children's Clinic in Jacksonville, Florida

Robert W. Hered, M.D. is a chief investigator at the Nemours Children's Clinic in Jacksonville, Florida. He is working to train pediatric offices through workshops and "hands on" support. In addition, an educational CD will be distributed to all pediatricians and family physicians throughout the state of Florida.

Public Education

The Children's Eye Foundation has embarked on a public education campaign with our spokesperson, Heisman trophy winner and Arizona Cardinal quarterback Matt Leinart. Matt is a successful strabismus patient who wore "Coke-bottle" glasses as a child. Both Matt and his parents are dedicated to speaking to the public about his story and the importance of vision screening in young children.

The Need

The World Health Organization keeps statistics on bilateral blindness, by cause, worldwide. The bilaterally blinding conditions that render children blind are, by contrast with cataract, glaucoma and macular degeneration, relatively few. By implication, and often by program design, the care of children is not given commensurate resources. However, if the concept of "blind years" is considered (referring to the total number of years a person might endure bilateral blindness), children's conditions rise to number two in ranking. Extending this calculation of blind years to individual eyes is likely to portray the burden of blindness in children to overshadow all other conditions. After all, children with one seeing eye are more likely to lose the second eye to a lifetime of risks for blindness in their remaining eye. This should raise the profile of programs that eliminate preventable blindness in children to primacy in programs of research, education, prevention and clinical care-all of which are currently undervalued and under-resourced. The Children's Eye Foundation seeks to redress this anomaly.

Each year, close to four million children are born in the United States. Research suggests that at least 1 in 20 and possibly even 1 in 10 of these children experience a vision disorder that can lead to permanent vision impairment if the disorder is not identified and treated.

The largest common pathway of disease leading to loss of vision in infants and children is amblyopia, generally resulting from optical errors and differences, misalignment of the eyes, and the presence of diseases that block the passage of light such as corneal scars and cataracts. These are known, respectively, as refractive, strabismic, and occlusion amblyopia. In each case, the resulting pathology resides in the visual brain, making amblyopia by far the most common reversible brain damage and the most cost effective neurosensory intervention in medicine. More vision is lost to amblyopia in the first 45 years of life than to all other conditions combined.

Based on the initial data collected and reported in the federal Department of Health and Human Services report, Healthy People 2010, 35 percent of children considered to be "poor" by government definitions had received a vision screening before the age of five. 38 percent of children defined as "near poor" are screened by this age, and only 36 percent of children that are defined as "middle/high income" have had a vision screening before age five.

Researchers estimate that the effect of amblyopia and other detectable vision disorders costs the United States up to $32 billion each year, and the cost of vision screening is estimated to be no higher than $1.5 billion, thus making vision screening an extremely cost effective endeavor.

Measuring our Success

During the course of this 18-month project, Bradford and Hered will train close to 150 pediatricians and their staffs using the guidelines set out by the American Academy of Pediatrics and the American Academy of Ophthalmology.

We anticipate that over 14,000 children will be screened in both states during the 18-month project. By training health care providers, the community benefit is amplified as these professionals continue to screen children after project completion.