Eye Health and Vision Care

Vision loss has been shown to cause substantial social and economic tolls, emotional suffering, social isolation, loss of productivity, and diminished quality of life. Despite the importance of vision and eye health on one’s quality of life, many people continue to face barriers to accessing the proper eye and vision care.

ACU works with local, state, and national partners to increase access to the proper eye and vision care for underserved populations. We do this by bringing mobile vision vans to underserved communities, providing grants and technical assistance to health centers to help establish permanent eye and vision programs at service sites, and educating communities of underserved populations.

New Initiative: Laying the Groundwork for a National Coalition to Increase Access to Eye Health and Vision Services via Community Health Centers

Community Health Centers (CHCs) were created to provide primary healthcare services to the nation’s most vulnerable and medically underserved populations, regardless of their ability to pay. Yet, only 1 in 4 (26%) CHCs nationwide offer vision services through an optometrist or ophthalmologist, and a mere 3% of the 34.5 million patients they serve annually can access them due to a multitude of systems-level barriers. When trying to establish or expand these services, health centers face high start up costs, space limitations, workforce challenges, and more due to the exclusion of vision services from the mandated scope of primary medical services under Section 330 of the Public Health Services Act, limited coverage under Medicare, state variances in Medicaid coverage for adults, and eye care providers’ exclusion from the National Health Service Corps.

The Association of Clinicians for the Underserved’s (ACU) white paper, A Roadmap for Community Health Centers to Establish and Expand Comprehensive Vision Services, provides an overview of the efforts over the last two decades aimed at addressing these challenges, but recently, there has been a significant increase in activity aimed at expanding access to vision services through health centers.  With the generous support of the Lavelle Fund for the Blind, ACU will conduct the first ever in-depth scan of national and state-level organizations working to expand access to vision services via CHCs with the goal of identifying opportunities for coordination and alignment of activities, as well as new synergies between organizations. Starting in March 2026, the scan will delve into these organizations’ current efforts, future goals, and gaps. Upon completion of the scan, ACU will synthesize this information into a draft report that summarizes recommended next steps, goals, and milestones across the following five areas: 

• Communications – Establish communication channels to disseminate resources and information developed by the coalition and participating organization
• Workforce & CHC Implementation – Develop a national strategy for supporting a thriving and sustainable eye care workforce, including pipeline development, recruitment & retention strategies, staff development and advancement, well-being initiatives, and ongoing workforce assessment, as well as a strategy for educating and supporting CHC leaders and staff
• Research and Data – Develop a set of research priorities that align with Healthy People 2030 objectives and demonstrate the value CHCs offer by improving access to vision services 
• Better Use of Technology, AI, and Mobile Health Solutions: Develop and/or disseminate guidance and recommendations for improving access to vision services through better use of technology, AI, and mobile health solutions at CHCs 
• Policy & Advocacy – Create educational resources and facilitate dialogue on federal- and state-level policies that support or create barriers to providing eye care at CHCs 

This report will be the foundation for establishing a national coalition that focuses singularly on improving access to vision services in all underserved communities. For more information about these efforts, please contact ACU’s Program Director, Luke Ertle at lertle@clinicians.org.   

Ongoing Work: Technical Assistance for Health Centers

In 2020, ACU launched the Vision Services Committee, a group of volunteer optometrist, health care administrators, academics, and advocates from across the country who are committed to increasing access to eye health and vision care for underserved populations. ACU works closely with the Committee to address the technical assistance needs of health centers to support successful and sustainable programs.  The 2025-2026 Vision Services Committee roster is available here!

Do you have any questions about starting up or expanding vision services at your health center? Are you looking to connect with the Vision Services Committee for technical assistance? Please reach out to ACU’s Program Director, Luke Ertle at lertle@clinicians.org.  

Resources:

2025 Health Center Vision Services Expansion Brief: Eye Care is Primary Care – This brief explains why eye care is an essential part of primary care and encourages community health centers to expand vision services. It highlights the growing need among patients, the benefits of integrating eye care into coordinated services, and the operational realities health centers face. The publication also identifies key challenges such as workforce limitations, coverage gaps, and startup costs while offering guidance for overcoming them. Overall, it provides a roadmap to help health centers plan, fund, and sustain vision care programs.

The Community Health Center Eye Care Workforce – This factsheet presents findings from HRSA’s Uniform Data System and ACU’s 2024 Health Center Eye Care Provider Survey that can be used to 1) improve recruitment and retention of eye care providers and position health centers as an employer of choice and 2) advocate for additional workforce support. This document builds off a 2023 community health center optometry workforce survey report available here.

A Roadmap for Community Health Centers to Establish and Expand Comprehensive Vision Services – This white paper presents barriers that community health centers face when establishing and expanding eye clinics through the lens of the National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division’s landmark consensus document entitled, Making Eye Health a Population Health Imperative: Vision for Tomorrow. The white paper also share’s ACU’s recommendations to address these barriers at the national, state, and local levels through five core action areas: 1) facilitating public awareness through timely access to accurate and locally relevant information, 2) generating evidence to guide policy decisions and evidence-based actions, 3) expanding access to clinical care, 4) enhancing public health capacities to support vision-related activities, and 5) promoting community actions that encourage eye and vision healthy environments.

FQHC Eye Care Services Billing & Coding: Tips & FAQs – This document is to serve as a reference for billing vision services within an FQHC setting.

FQHC and Community Optometry – This Facebook group provides a place for optometrists working in community health centers to connect and discuss the unique challenges they face.

Integrating Eye Health and Vision Care for Underserved Populations into Primary Care Settings, 2020 – This publication by the American Optometric Association and the Association of Clinicians for the Underserved provides information about the current need and best practices for delivering health care services as part of integrated care models

Webinar Recordings:

• Introduction to Comprehensive Vision Services in Health Centers reviewed the interconnection of vision, chronic disease and quality of life. Learners will review the data substantiating community needs, disparities and barriers.
• Steps for Integrating Comprehensive Eye Health and Vision Services Into Health Centers reviewed the operational activities necessary to implement or enhance vision services in a health center. Learners will review planning factors such as provider configuration, cost, volume and supervision
• We’ve Decided to Offer Vision Services in Our Health Center, Now What? takes a deeper dive into the feasibility of opening an optometry department within a community health center.
• Billing for Vision Services, along with its accompanying Billing Office Hours, is a deep dive into how health centers can align their billing procedures for vision services with their existing service lines.
• Children’s Vision and Eye Health in Community Health Centers, Part 1 discussed common vision disorders among children, best practices for vision screening and assessment by primary healthcare providers (PCPs), and strategies for completing referrals for eyecare.
• Eyes on Access: Children’s Vision and Eye Health in Community Health Centers, Part 2 discussed four models of vision care for children in CHC
• Healthy Eyes, Healthy Lives: Community Approaches to Children’s Vision and Eye Health shared school-based eye care models from across the country.
• Eyes on the Workforce: Strategies for Recruiting and Retaining a Thriving Eye Care Workforce educated community health center leaders and optometrists about strategies to recruit and retain a thriving eye care workforce.

Vision Services Readiness Assessment, 2020 – a short questionnaire for health centers to assess their readiness to start an eye health and vision care program. Assessment results include resources such as a vision equipment cost calculator

The National Eye Institute’s National Eye Health Education Program – an extensive library of patient education resources and tools in different languages

Integrating Eye Services into Primary Care, 2021 – developed by Prevent Blindness, this resource includes recommendations and a sample business plan for health centers.

American Optometric Association’s Business Model – this tool walks health centers through how to create a business model when starting up an eye and vision care program.

Optometry in Health Centers Budget and Equipment List –  this resource provides a list of equipment necessary for starting up an eye and vision care program and includes cost estimates.  Available in both pdf and spreadsheet.

Looking for more info about ACU’s programs or sponsorship opportunities? Please contact ACU’s Program Director, Luke Ertle.

Past Work: Health Center Grants

Mobile Vision Clinics

Since 2017, ACU has partnered with schools and health centers to provide over 3500 vision exams through mobile vision clinics. Over 56% of the people who had an examination at a mobile vision clinic needed prescription glasses which were provided in the days following the events.

Startup and Expansion Grants for Permanent Eye Health and Vision Clinics

The provision of on-site, comprehensive eye and vision care speaks directly to the mission of health centers to provide primary, preventive health care services. As such ACU provides small grants to federally qualified health centers (FQHCs) and look-alikes to support the costs of vision equipment and supplies. Since 2018, ACU has assisted twenty-nine FQHCs in establishing and expanding permanent eye health and vision care programs.

A 2021 grantee of the program, PrimaryOne Health in Columbus, Ohio, used funds to support the purchase of an optical coherence tomography (OCT) machine for their East Main Street location. This machine is currently being used to diagnose and help treat individuals with glaucoma and retinal diseases like age-related macular degeneration and diabetic eye disease. It has expanded and enhanced their ability to provide comprehensive care for their vulnerable patient population of individuals from communities disproportionately impacted by these issues.

“Having to refer our patients to another site meant that we were sometimes exacerbating the transportation, scheduling, and/or financial barriers faced by the patients. In the area served by the site, nearly 33% of the population is considered low income, and 59.2% of the population is at or below 138% of the federal poverty line and/or uninsured. Referring our patients elsewhere would significantly decrease the likelihood that our patients would go on to receive the follow-up care they need at a price they could afford. By providing low-cost vision care services to our patients, we can ensure that they have access to quality eye care, regardless of their ability to pay.”

– Gregary Graves, OD

PrimaryOne Health, Columbus, OH

Click the links below to learn more how some of the grantees used their funds as well as the impact on patients.

• Summary of  Vision Service Program Grantees – overview of the start up or expansion programs for 29 health centers funded by ACU.
• Patient Impact Stories – patients of health centers who received grants from ACU shared the impact that improved access to vision services has had on their life.