NORTH CHARLESTON — Inside the colorful van parked outside Midland Park Primary School, 5-year-old Marivaleria Hernandez Bautista must confront a question she has never faced before.

“I want the purple glasses,” she said in a quiet, mouse-like voice. In addition to her eye exam, she will get not one but two pairs of eyeglasses, and they will be free thanks to a national nonprofit with a strong presence in Charleston and South Carolina.

Vision to Learn, an organization begun in Los Angeles in 2012, has been operating in Charleston County schools since 2021 and in Dorchester County since last year. As of Jan. 20, the nonprofit has provided 8,467 eye exams in Charleston County and 6,775 students have received glasses, while Dorchester School Districts 2 and 4 have received 2,627 exams and 2,182 students received prescription glasses.

Nationally, the program operates in 14 states, including South Carolina, North Carolina and Georgia, and has examined more than 3.3 million children and given out more than a half-million pairs of glasses. It is based on a simple idea: a kid who can’t see well is going to have a hard time learning.

As many as one in four children may have some form of eye problem or difficulty seeing, and an estimated 857,000 currently have difficulty seeing or reading, according to the American Public Health Association. But the problem often goes undetected before they get to school.

Only about one in five preschool children get screened for vision problems, and less than 15 percent receive an eye exam, according to the Centers for Disease Control and Prevention. 

Vision to Learn estimates that one in five low-income kids lack the glasses they need to see clearly and do well in school. They usually don’t know they have a problem, said Cory Davis, an optician with Vision to Learn in Charleston. 

“If they’ve never seen clearly, they have no point of reference (for) what is clear or blurry,” she said in the Vision to Learn mobile eye exam van.

“Kids just go off what they see,” said Dr. Nicole Nowling, an optometrist with Vision to Learn.

It is one reason why the screening programs with Vision to Learn are so important. The program goes to Title 1 schools to do widespread screening of students for potential vision problems.

“We work closely with teaches and school nurses,” who may notice a child is struggling, squinting or appears to have vision problems, Nowling said. The program also uses an autorefractor camera, which can look at the lenses in a child’s eyes and gauge how well they can see.

Vision to Learn has screened nearly 22,000 kids in Charleston County so far. From those come the referrals for eye exams, and the vans travel around the district regularly to conduct them.

The optometrist and opticians do their best to make the insides of the vans cheerful, and optometrist Kelly Willard said she tries to keep the atmosphere light and upbeat.

“I want them to think of it as we’re having a good time while you’re getting your eyes examined,” she said.

Inside the van at Midland Park, there are red, green and purple twinkling lights. A calming video of ducks on a pond plays on a monitor, and there are posters of dogs wearing glasses around the walls. But there is also serious equipment aboard.

“Everything you can get at a regular optometrist’s office, you can get here,” except for drops to dilate the eyes, Davis said. But they can do all of the exams they need.

Davis, for instance, takes a long camera with an eyepiece at one end and looks through it while 5-year-old Santiago Roblero Vazquez presses his face up against the other end. The camera has a wide-angle lens that allows Davis to not only look into the eye, but to take a detailed photo of the back of the eye to show the blood vessels and nerves.

She shows Santiago’s photo to Nowling, who nods her approval. It can show whether there is something rare and serious, like a swollen optic nerve.

“For those, there are urgent referrals,” and the child could be sent directly to the emergency room. That swelling could be a sign of high intracranial pressure, or pressure inside the skull, as it was in the case of a child Willard saw in November. Fortunately, that child was treated before it could cause something worse, like a seizure. If left untreated, a child could lose vision permanently, Nowling said.

At one end of the van, Nowling is doing a retinoscopy, shining a light in the child’s eyes as they look through double lenses. It allows her to get a sense of how far off the child’s vision might be, and then she can adjust that as she goes along.

“It allows me to come up with a glasses prescription for the child, without them having to really respond at all,” Nowling said.

Then it can be adjusted with other measures, such as having the child look through the corrective lenses to read off the eye chart. It can also help to overcome some communication or language barriers.

A small H was projected on the screen several feet from Santiago, but he was struggling to follow directions during the exam.

“What sound is that?” Nowling tried.

“Hah,” Santiago said.

“Good job!” Nowling said.

All of that information helps shape the prescription.

“That way, we have objective things and subjective things” to use, Davis said. “And if those are really not matching, we can explore some more.”

During the visit, kids can also check out a wide range of frames, and Marivaleria ends up with rose-colored ones that make her smile.

That is the other exciting event for Vision to Learn: dispensing day, when kids actually get their glasses. It is becoming a big deal at Northwoods Middle School, said Principal Keturah Gadson.

The program “has created such a buzz among students” that she hears talking as they walking down the hall on the days they are to be delivered. Of the roughly 700 students at the school, Vision to Learn screened 665, then 268 received eye exams and 218 got glasses. Gadson expects it to have a big impact.

“I know those kids are going to really soar because one hindrance is out of the way,” she said. “And that’s a lot of kids.”

About a half-dozen were waiting in a classroom in front of a table filled with a rainbow of frames inside their pouches. It is a different world than when Gadson first started wearing glasses in middle school, where even though she liked her wire-frame glasses she was “really self-conscious” about wearing them.

Willard, too, recalls the sting of being labeled “four-eyes” by classmates. But she also remembers how her glasses filled her with confidence, raising her hand to answer questions because now she could read the board. And as a voracious reader, they provided much-needed relief.

“Being able to read longer and not get a headache, it was all fun,” Gadson said. “The embarrassment quickly passed.”

There are no such issues with Northwoods students and the wide range of colors and style they can choose from. They “get to have a personality” with their glasses,” Gadson said. “They get to be unique and creative and own their look.”

That’s apparent as Willard calls them up to try on their new frames and adjust them if needed. She lets them check themselves as she holds up “the world’s smallest mirror” and jokes around with them.

“I’ve always liked working with kids,” Willard said. “I have the sense of humor of a kid.”

The moment they see themselves in the mirror catches some off-guard. Dyeimi Cruz Lopez, 12, covers her mouth in shock at the first glimpse of her silvery new glasses.

“Oh my gosh,” Gadson said with a gasp. “Those are really pretty.”

“They look good,” Willard told the sixth grader.

This isn’t the first pair of glasses for Dyeimi, but they are a chance to go in a new direction.

“I wanted to try something different,” she said.

And she got it.