School Vision Program (NYC)

School Vision Program (NYC) is sponsored by New York City Department of Health and Mental Hygiene (DOHMH) and Department of Education (DOE). This opportunity supports mission-aligned projects and measurable outcomes.

## [](https://pmc. ncbi. nlm.

nih. gov/articles/PMC8769361/)Abstract This study describes how the School Vision Program (SVP) operates in NYC Public Schools, and how it has expanded to provide screening, follow-up, eye exams, and even glasses to more students in recent years.

Using administrative data from the SVP, we analyze a population sample of all public-school students with non-missing demographic variables in grades Pre-K through 12, focusing on the most recent year of data, 2018–19. We tabulate rates of screening and other results across students by grade and student characteristics, highlighting the expansion of SVP in community schools beginning in 2015–16.

The SVP screens about 87% of students in Pre-K through 1 st Grade each school year. Of the 22% of screened students who failed the screening in 2018–19, 69% received follow-up efforts, and 39% completed eye exams. Among students with completed eye exams, 13% of students in Pre-K through 1 st grade were diagnosed with amblyopia, and 70% needed glasses.

Less advantaged students in terms of race, ethnicity, and socioeconomic status were less likely to pass vision screenings and less likely to receive eye exams after failing the screening.

The SVP’s expansion to all grades in community schools and its provision of eye exams and glasses increased the rate of eye exams to 90% of students with a failed vision screening and distributed glasses to over 22,000 students in grades Pre-K to 12 in 2018–19. The expansion of SVP services in community schools suggests large potential benefits from school districts connecting students who fail vision screenings directly to eye doctors.

Otherwise, low rates of follow-up eye exams in younger grades can lead to unidentified and unmet need for vision services in older grades, especially among disadvantaged students. ## [](https://pmc. ncbi.

nlm. nih. gov/articles/PMC8769361/)Background ### School-based vision services in the United States Delivering high-quality health programs in a school-based setting provides a promising approach to eliminating health disparities, as services offered during school hours and on school grounds yield exceptional reach [1].

The critical link between the health status of children and their educational success has propelled the implementation of diverse health programming in schools. The Office of School Health (OSH), a joint bureau of the New York City Department of Health and Mental Hygiene (DOHMH) and Department of Education (DOE), provides a broad range of health services to students in New York City (NYC) schools.

Specific programs, like the School Vision Program (SVP), seek to identify students throughout the NYC school system who are at high risk for vision deficiencies that may be hindering their academic achievement. Vision deficiencies, including refractive error and other vision disorders, are common among school-age children, yet most are treatable if caught early.

A report from the National Academies of Sciences, Engineering, and Medicine (NASEM) details the prevalence and treatability of different types of vision problems among children in the United States [2]. According to that report, refractive errors, which include conditions such as myopia, hyperopia, and astigmatism, are present in at least 20% of children. These conditions can be corrected by adhering to prescribed eyeglass use.

Amblyopia, commonly referred to as “lazy-eye,” affects an estimated 1–3% of young children and can lead to blindness in one or both eyes if gone undetected in early childhood. Strabismus, a condition that interferes with an individual’s depth perception and often leads to amblyopia, affects 2–4% of young children.

Though not as easily corrected as refractive error, the early detection of amblyopia and strabismus provides the best opportunity for effective treatment [2]. Once detected, it is important for children with vision deficiencies to receive follow-up care after a failed screening and adhere to treatment.

Visual impairments noticed but unattended to during early childhood may lead to worsened visual acuity as well as academic underperformance. Unclear vision is a significant barrier to literacy, and students who do not reach the desired reading levels by the end of 1 st grade miss the first benchmark of academic achievement [3].

Students who may have trouble reading or seeing blackboards may abstain from participating in class discussions and show overall decreased motivation in the classroom [3,4]. In addition, difficulty seeing may impair children’s physical health if it makes physical activity more difficult. There are clear disparities in vision treatment by race and socio-economic status as well as some documented differences in underlying vision health.

A 2012 analysis of trends in racial/ethnic disparities of child health in the U.S. showed that Black children had significantly higher reports of vision problems compared to White children [5].

Summarizing studies that have measured refractive error among young children by race and ethnicity, Welp and colleagues report somewhat higher rates of astigmatism among Hispanic children relative to non-Hispanic children, but higher rates of hyperopia among non-Hispanic White children relative to non-Hispanic Black and Hispanic children [1].

Among older children, ages 12–19, Qiu and colleagues find significant disparities in vision treatment by both race/ethnicity and socioeconomic status (SES), with Hispanic and non-Hispanic Black teenagers and those of lower SES less likely to have their refractive errors adequately corrected [6].

Patterns in large U.S. cities like Philadelphia and Los Angeles similarly show that a child’s race/ethnicity and SES are correlated with accessing eye care when needed [7,8]. School-based vision programs that serve diverse populations are well-positioned to reduce disparities in vision acuity and in access to vision care.

However, early studies of the effectiveness of traditional school-based vision programs found that many students who fail vision screenings do not ultimately receive treatment [9]. This is an issue in school-based vision programs that provide screenings only and recommend families to seek vision care.

Shakarchi and Collins review a dozen studies of school-based vision programs that provide screening as well as eye-exams and glasses prescriptions [9]. They refer to these as “school-based eye care programs” to contrast them with traditional screening programs (p. 860).

Though varying widely in design and number of students served, these programs achieved high rates of eye-exams among those failing the initial vision screening. These programs include the Baltimore Vision Project, Philadelphia Eagle Eye Mobile, UCLA Preschool Vision Program, and Toledo Public Schools Eye Care Program, among others [9].

Our analysis of the NYC School Vision Program contributes to the literature that describes and evaluates such programs. We provide a descriptive analysis of the expansive School Vision Program operating in NYC public schools. In addition to providing a detailed picture of screening, follow-up efforts, eye exams, and abnormal diagnoses in school year 2018–19, we describe how the program’s reach has expanded over time since 2010–11.

In particular, we report rates of screening failure, follow-up exams, and diagnoses after the SVP expanded in a subset of high-need schools to cover older students and to provide eye exams directly. The results of this analysis have lessons for other school districts seeking to expand the reach and effectiveness of their vision screening programs.

### The NYC Office of School Health School Vision Program The School Vision Program (SVP), housed in the Office of School Health, was formed after state and city-level mandates required that, at a minimum, all students be screened for vision deficiencies.

New York State vision screening guidelines mandate that in-school screenings be conducted for all new entrants, within six months of enrollment, Kindergarten, 1 st, 3 rd, and 5 th grade students. NYC policies indicate that the DOHMH be responsible for conducting all Pre-K (PK), Kindergarten (K), and 1 st grade screenings, and the SVP implements these DOHMH vision screenings [10].

In recent years NYC has expanded the SVP in community schools by screening students in all grades PK-12 and by providing vision care directly, including eye exams and free glasses. Community schools are a subset of 250-plus high-need schools that offer additional social and health services to students and their guardians.

Located throughout the city and including elementary, middle, and high schools, these schools were selected for the program based on low attendance, high drop-out rates, and lower academic performance. Expansion of the SVP in community schools began in the 2015–16 academic year. Screenings in community schools cover grades 2–12 in additional to the regular screening for grades PK-1.

Mayoral funding and public-private partnerships additionally enable all students in these settings to receive eye exams and glasses, if needed. While students in community schools are a somewhat unrepresentative subset of NYC students due to how schools were selected, the results that we present here are suggestive of the benefits of expanding the SVP to other schools. ## [](https://pmc.

ncbi. nlm. nih.

gov/articles/PMC8769361/)Data and methods We use administrative data from the SVP linked to student demographic data from the DOE covering students who attended public schools in grades PK-12, from 2010–11 to 2018–19.

Variables related to vision screening and follow-up come from data reported by SVP staff, and variables related to eye exams and abnormal diagnoses were entered by SVP staff from forms filled out by the optometrist who performed the student’s eye exam. Among about 2. 5 million students who appear as screened through SVP, 2.

3% do not appear in DOE demographic student files, possibly due to leaving the public-school system before the end of the school year and are not included in our sample. Out of about 10. 2 million students, screened and unscreened, in the demographic student files, 2.

2% are either missing grade information or are not in grades PK-12. An additional 0. 9% are missing at least one of gender, race/ethnicity, or free or reduced-price lunch status variables, leaving a sample of 9,901,434 students across all years and 1,107,685 students in 2018–19.

This paper aims to use the rich administrative data collected through the SVP over the last several years to describe in detail how the program operates and how it has expanded to reach more students with more vision care services over time.

The size of the SVP population and level of detailed data collected and entered by SVP staff allows us to provide a fuller picture of a school vision program (and the prevalence of vision problems it uncovers) than has previously been available.

Rather than test a hypothesis of the effect of SVP on student outcomes or test for differences in vision by student characteristics, we focus on tabulating several key measures that capture the direct outputs of the SVP: the rate of vision screening among enrolled students, the rate of screening failure among screened students, the rate of follow-up among students that fail vision screenings, the rate of confirmed eye exams among students that fail vision screenings, and the rates of various abnormal diagnoses among students with confirmed eye exams.

Because the main population served by the SVP are students in grades PK-1, our analysis focuses on this population. However, by showing the same key measures of interest for older students in community schools in 2015–16 and later, we show just how many students fall through the cracks, such that their vision problems persist unresolved or develop at an older age.

Furthermore, we show the difference between the rate of confirmed eye exams among students that fail vision screenings when those eye exams are provided directly through the SVP rather than placing that burden on students’ families. ### Description of population The NYC public school system is the largest in the U.S. and has a diverse student body in race/ethnicity and SES.

In the 2018–19 academic year, 1,107,685 total students were enrolled in the NYC public schools in grades PK-12 (Table 1). Of the total enrolled population, 51. 4% of students were male, and approximately 15.

3% were non-Hispanic White (White), 25. 7% non-Hispanic Black (Black), 41. 1% Hispanic, 16.

5% Asian or Pacific Islander (Asian), and 1. 5% multiracial or missing race/ethnicity information (other). About 74.

1% were identified as individually eligible for free or reduced-price lunch or Human Resources Administration (HRA) benefits (e.g., Supplemental Nutrition Assistance or Temporary Assistance for Needy Families), an indicator used to characterize children living in low-income households. Beginning in school year 2017–18, all students received free school meals throughout NYC schools.

However, the Department of Education continued to identify students individually eligible for purposes of reimbursement from the National School Lunch Program. (Note that the free or reduced-price lunch variable is an imperfect measure of economic disadvantage, because not all income-eligible families provide this information to schools, and neither do all income-eligible families participate in SNAP or TANF.) Table 1.

Summary of demographic characteristics of students enrolled in NYC public schools and students screened by the School Vision Program, 2018–19. Notes: These data come from a merge between DOE’s student demographic data file and the SVP’s student program data file. Screened students are a subset of enrolled students; the rightmost column is equal to the number screened divided by the number enrolled.

Non-Geographic Districts include alternative schools and schools serving students with disabilities. Among those enrolled in 2018–19, about 24. 0% received in-school vision screening.

Screening rates were between 78. 2% and 86. 8% among students in grades PK-1; students DOHMH is responsible for screening.

Those not screened in these younger grades were absent from school or could not be tested because of other outstanding medical issues. Those screened in older grades attend community schools. Demographic characteristics of the screened population closely match those among the broader enrolled population.

## [](https://pmc. ncbi. nlm.

nih. gov/articles/PMC8769361/)School Vision Program for Pre-K, Kindergarten, and 1st grade students ### Overview of program procedures The school vision program operates through several teams that collaborate to provide vision screenings, follow up with families, perform eye exams through the optometry program, and enter data into student health records.

Twelve K-1 teams are assigned geographically, led by a Team Leader and Public Health Advisor, and staffed by three Public Health Assistants. An optometrist provides technical assistance and consultation to the teams and OSH school-based staff. The Team Leader plans the logistics of the screening with the respective principals and is responsible for all statistical data, while the Public Health Advisor coordinates with school nurses.

Screeners measure distance and near vision, fusion, and color vision. The teams use one of three tests (Snellen, tumbling E, or Lea Symbol chart) for distance vision. Near vision is tested with a Rosenbaum pocket chart and a +2.

50 flipper lens. Color vision is tested with an Ishihara unlettered version book, and fusion with the Lang stereo test. The teams are responsible for entering all screening data into ASHR using laptops provided by the program.

The PK screening staff, consisting of Public Health Advisors, use the Welch-Allyn Sure Sight and SPOT auto-refractors to screen children in the DOE Universal Pre-K Program. The Lea Symbol Chart may also be used if a K/1 st grade screening team member screens a PK student. The OSH has a policy agreement with the DOE to provide this screening service, both in public schools and in community-based organizations.

PK screeners schedule and screen their schools and enter their screening results into the Automated Student Health Record (ASHR).

Children who fail vision screening in PK, K, or 1 st grade, or who cannot be tested, are sent home with 1) a letter advising the parent to take the child to an eye doctor, 2) an eye report and recommendation form (E12s) for the eye doctor to fill out, 3) a list of public facilities that will enroll children without insurance, and 4) a pre-addressed, postage paid envelope in which the parent can return the completed eye form to the OSH.

Follow-up begins immediately after screening, with calls alerting parents to the letter and E12s form that will be in their children’s backpack. The follow-up unit, which consists of one supervisor and five Public Health Advisors, receive priority lists from field staff to contact parents of children in grades K-1 based on their vision screening results.

In grades K-1, children receive priority for follow-up when their vision screening score is 20/70 or worse, or when their results suggest a risk for amblyopia due to a difference of two lines or more between right and left eyes in distance vision. All PK students who fail the screening should also receive follow-up. Subsequent calls are made every two weeks to encourage and assist the parent in finding pediatric eye care.

If the family cannot be reached by phone, the unit sends a letter. Some families require only one phone call to take their child to the eye doctor; others require innumerable intervention attempts. For families seeking assistance with eye care providers, the follow-up unit refers children to select ophthalmologists.

The unit assists families in need of health insurance and visits schools if necessary to contact hard-to-reach families. The goal is to get every child with poor vision to an eye doctor. Students with confirmed eye exams have returned referral E12s forms with exam results as filled out by their eye doctor.

The data entry unit, consisting of one supervisor and four staff members, enters the data in these returned forms into ASHR. The staff of the data entry unit is also responsible for collecting any missing information on the E12s forms by contacting the doctor’s office or contacting parents.

After receiving all the missing information, the updated data are entered into ASHR and a copy of the E12s form is mailed to the school nurse for the child’s file. In school year 2018–19, about 78% of PK students received the in-school vision screening described above, while about 87% of students in grades K-1 were screened (Table 2).

Attendance is often lower in PK than later grades [11]; lower attendance on vision screening days may partially explain a lower rate of screening in PK. Rates of screening among grades PK-1 have changed little over time since 2010–11, ranging from about 87 to 88% each year. Table 2.

Rates of screening, failed screening, follow-up, and confirmed exams in Pre-K to 1 st grade, 2018–19. Notes: These data come from a merge between DOE’s student demographic data file and the SVP’s student program data file. While some students who passed the vision screening obtain eye exams, the “Exam Confirmed” column is calculated using only those who also failed the vision screening.

### Screening failure and follow-up rates Among the 193,084 students in grades PK-1 screened in 2018–19, about 22. 2% failed the screening. This percentage varied little by grade, with between 21.

0% and 23. 3% failing the screening in each of these three grades (Table 2). Rates of vision screening failure have changed little over time since 2010–11 when 19.

6% of screened students in grades PK-1 failed the screening. What has changed over this time period are rates of follow-up in response to failed screenings. In 2018–19, among 42,827 students in grades PK-1 that failed their vision screenings, about 69.

1% received follow-up efforts from staff (Table 2). This number averages a high rate of follow-up among PK students, 97. 3%, and rates of 57.

0% and 57. 9% for students in Kindergarten and 1 st grade, respectively. These percentages translate into nearly 30,000 students in these grades that received follow-up communication efforts following vision screening failure.

Rates of follow-up for students who failed vision screenings in grades PK-1 have increased over time, from 42. 7% in 2010–11 to nearly 70% in the latest year of data. ### Rates of confirmed eye exams Despite follow-up efforts, not all students who fail their vision screening will complete an eye exam and return the E12s form with their exam results.

Among those students who failed the vision screening in 2018–19, 38. 8% were confirmed to have had eye exams because they returned completed E12s forms (Table 2). Rates were slightly higher for students in PK than for students in grades K-1 (42% versus 37%), but not as much higher as the rate of follow-up for PK would suggest (97% versus 57%).

Similarly, while rates of confirmed exams have increased slightly since 2010–11 (from 37. 7% in 2010–11), they have not increased in proportion to the increase in follow-up rates. ### Rates of abnormal diagnoses Among those students confirmed to have received eye exams (E12s forms returned), about 90.

6% received diagnoses of vision problems from their optometrists (Table 3). Optometrists can report up to three diagnoses for each student. In 2018–19, about 13.

0% of students with confirmed eye exams were diagnosed with amblyopia, 0. 3% with strabismus, 31. 1% with hyperopia, 23.

8% with myopia, and 66. 6% with astigmatism (note that these are not mutually exclusive categories).

(We identify students as having: (1) amblyopia if any of their diagnoses are “Amblyopia”, “Refractive/ametropic amblyopia”, “Strabismic amblyopia”, “Deprivational amblyopia”, “Organic amblyopia”, or “Meridional amblyopia”; (2) strabismus if any of their diagnoses are “Strabismus” or “Strabismic amblyopia”; (3) hyperopia if any of their diagnoses are “Hyperopia/hypermetropia” or “Hyperopic astigmatism”; (4) myopia if any of their diagnoses are “Myopia” or “Myopic astigmatism”; and (5) astigmatism if any of their diagnoses are “Astigmatism”, “Hyperopic astigmatism”, or “Myopic astigmatism”.)

About 69. 9% of students with confirmed eye exams were determined by optometrists to need glasses, which translates to about 5. 2% of students in grades PK-1 determined to need glasses through the School Vision Program’s screenings.

Table 3. Rates of abnormal diagnoses among screened students with eye exams confirmed in Pre-K through 1 st grade, 2018–19. Notes: This table includes all students with confirmed eye exams, including those that passed the vision screening.

The diagnoses are not mutually exclusive, and “Any Abnormal Diagnosis” encompasses more diagnoses than those listed in the table. Rates of different vision problems varied somewhat by grade. Rates of myopia and strabismus increased with grade, while rates of amblyopia, hyperopia, and astigmatism decreased with grade.

The rate of needing glasses increased with grade from 64. 6% among Pre-K students to 77. 0% among 1 st graders who received eye exams.

It is important to note that these patterns by grade reflect differences in which students obtain eye exams as well as differences in the underlying prevalence of vision conditions by grade. For example, the prevalence of amblyopia may decline with grade in this data partially because students with signs of amblyopia already received the diagnosis after an earlier screening.

Rates of abnormal diagnoses have also changed somewhat over time. Rates of any abnormal diagnosis have remained close to 90% over the years, and rates of needing glasses have varied between 70 and 75%. Rates of hyperopia have increased slightly, rates of amblyopia have decreased slightly, and rates of astigmatism have increased from about 58% to about 68% over this time period among students with confirmed exams.

### Variation by student and school characteristics In this section, we examine how rates of screening, screening results, follow-up, exams, and exam results among students in grades PK-1 varied by student and school characteristics in school year 2018–19. We show in Table 4 how these rates vary by students’ gender, race/ethnicity, and SES, as well as absence rate and whether students attended a community school or not. Table 4.

Rates of screening, failed screenings, follow-up, and confirmed exams by student and school characteristics, among students in Pre-K through 1 st grade, 2018–19. Note: These data come from a merge between DOE’s student demographic data file and the SVP’s student program data file.

While some students who passed the vision screening obtain eye exams, the “Exam Confirmed” column is calculated using only those who also failed the vision screening. Rates of follow-up in community schools are not applicable, because screening and exams are both provided by the SVP. Rates by absence use data from 2017–18 due to data availability.

Chronically Absent is defined as missing 18 or more days of school (10% of school days). Regular Schools are defined as all schools that are not Community Schools. Rates of screening, follow-up, and exams vary by how often students are absent from school and by whether students attend a community school, as these can directly determine access to services.

Students who are absent more often are more likely to miss the day of vision screening, and students who attend community schools have access to free eye exams, as discussed in the next section. Chronically absent (missed 18 or more school days) students were ten percentage points less likely to be screened for vision than those who were not chronically absent (78. 7% versus 88.

7%). Students who attended community schools were nearly ten percentage points more likely to be screened (92. 5% versus 83.

4%) and significantly more likely to receive eye exams (85. 6% versus 33. 0%).

While SVP screenings are provided to students of all backgrounds, disparities in screening by absenteeism carry over to disparities by race/ethnicity and SES. White and Asian students were screened at a rate of about 90%, while Hispanic, Black, and other students were screened at closer to 80% rate. Students not eligible for free or reduced-price lunch were five percentage points more likely to receive screenings.

Disparities in vision screening failure are more significant. Conditional on being screened, Hispanic students failed the vision screening at twice the rate of White students, and students eligible for free or reduced-price lunch failed at a rate about 50% higher than other students.

Since screening is done with glasses if a child already has them, this may be because these students are less likely to have received screening and treatment for vision problems before school entry than their counterparts.

While follow-up efforts were relatively similar across racial/ethnic groups, White and Asian students were still more likely to have confirmed eye exams than Hispanic and Black students conditional on having failed the vision screening (see Table 4). Similarly, students who were ineligible for free or reduced-price lunches were more likely to get eye exams after failing the screening.

Conditional on having confirmed eye exam results, which varies by student characteristics as described above, the rates of different abnormal vision diagnosis also vary by student characteristics. As shown in Table 5, students ineligible for free or reduced-price lunch were less likely to receive most of these abnormal diagnoses and less likely to need glasses.

The exceptions were amblyopia and hyperopia, with which students not eligible for free or reduced-price lunch were slightly more likely to be diagnosed. Differences by race/ethnicity were larger in magnitude and more complex. For example, Black students with confirmed exams were most likely to need glasses (75.

9%) and most likely to be diagnosed with myopia (29. 1%), but least likely to be diagnosed with amblyopia (10. 7%).

White students were least likely to need glasses (59. 5%), but most likely to be diagnosed with hyperopia (38. 9%) and amblyopia (15.

4%). Hispanic students were most likely to be diagnosed with astigmatism (72. 5%).

These diagnoses rates are only measured among students with completed eye exams, making it difficult to interpret the differences in diagnoses as differences in underlying prevalence. However, the higher rate of astigmatism among Hispanic students and the higher rate of hyperopia among non-Hispanic White students are consistent with other studies of refractive error among children by race and ethnicity [2]. Table 5.

Rates of abnormal diagnoses by student characteristics, among students in Pre-K through 1 st grade, 2018–19. Notes: This table includes all students with confirmed eye exams, including those that passed the vision screening. The diagnoses are not mutually exclusive, and “Any Abnormal Diagnosis” encompasses more diagnoses than those listed in the table.

## [](https://pmc. ncbi. nlm.

nih. gov/articles/PMC8769361/)Optometry programs for at-risk students In addition to the vision screening and follow-up efforts described above, OSH also provides free eye exams and glasses to certain at-risk students. In its longest-running optometry program, OSH has provided eye exams and glasses to students in grades 1–3 who are at the highest risk for amblyopia since 2010–11.

In a new program begun in 2016–17, OSH provides these same services to students of all grades whose families live in temporary housing. The optometry program for students at risk of amblyopia operates in a subset of NYC public schools, chosen based on the number of students who failed vision screenings but did not see an eye doctor in the previous school year.

Optometrists hired as medical consultants for the DOHMH conduct eye exams for those students at risk for amblyopia who do not return medical documentation from an eye care provider through this program. If the optometrist determines that a student requires eyeglasses, optical vendors under contract to the DOE provide the eyeglasses.

In the most recent year for which data are available, 2017–18, this program operated in 250 schools, providing over 4,500 students with eye exams and providing 3,932 pairs of glasses. OSH provides almost as many free pairs of glasses through a newer program begun in school year 2016–17 for students in temporary housing.

Like the program for students at risk of amblyopia, the program for students in temporary housing operates in a subset of schools identified by the DOE as having the largest number of students in temporary housing. In 2017–18, this program provided about 3,500 students across 49 schools with free eye exams and glasses.

While not as large as the community schools expansion discussed in the next section, these optometry programs deliver targeted services to subgroups of hard-to-reach students. ## [](https://pmc. ncbi.

nlm. nih. gov/articles/PMC8769361/)Community school expansion ### SVP in community schools School Vision Program services have expanded to include all grades in NYC’s community schools.

These schools are identified based on academic vulnerability but represent an opportunity to provide expanded services to more students who may also be at risk for poor health. Expansion of the SVP began in the 2015–16 academic year, with an additional 32,874 students in grades 2–12 receiving vision services through programming in community schools.

Since that time, the number of community schools has increased, and with it, the number of students receiving vision screening through this expansion, to 72,428 students in grades 2–12 in school year 2018–19. Most community schools are classified as Attendance Improvement and Drop-Out Prevention (AIDP) Schools or Renewal Schools.

AIDP schools are 45 grant-funded schools that follow the classic, national community school model by partnering with community organizations to offer various social and behavioral services for both students and guardians. Renewal Schools selected for the mayoral initiative met several criteria for being low-performing schools academically.

Mayoral funding and public-private partnerships with the nonprofit organization Helen Keller International (HKI) and the optical company Warby Parker have enabled all students in these settings to receive free eye exams and glasses if needed. By expanding the reach of SVP, children