Impact Story Submission Form

Thank you for sharing your story. These stories help demonstrate how Optometry Giving Sight supporters are helping train, establish and deliver optometry around the world.

Please complete as much information as possible and include photos and videos whenever available.

Refractive error related stories - relating to your project!

What challenge, barrier, or need existed before the project?

Examples:

• Limited access to eye care
• Lack of trained professionals
• No local vision center
• Difficulty learning due to poor vision
• Limited clinical training opportunities

What support was provided through the project?

Examples:

• Eye examination
• Glasses
• Professional training

Please provide specifics of any diagnosis (e.g. high myopia)

What changed as a result?

Please provide specific examples and outcomes.

Examples:

• Student can now see the classroom board.
• Teacher observed improved academic performance.
• Graduate now serves patients in an underserved area.
• New vision center now serves 500 patients annually.
• Faculty member gained new teaching skills.
• Community members can access care locally.

Please include at least one quote whenever possible.

Please include any measurable results related to this story.

Examples:

• Number of patients served
• Number of students trained
• Number of eye examinations provided
• Number of glasses dispensed
• Number of clinics established
• Number of schools reached

Photo 1 - Portrait

A clear, smiling photo of the featured individual or group.

Preferred:

• ✓ Looking at camera
• ✓ Good lighting
• ✓ Clean background
• ✓ High resolution

Photo 2 – Action Photo

Examples:

• ✓ Eye examination
• ✓ Student learning
• ✓ Clinical training
• ✓ Faculty teaching
• ✓ Community outreach
• ✓ Vision center operations

Additional Photos (Strongly Encouraged)

Examples:

• ✓ Classroom environment
• ✓ Patients receiving care
• ✓ Vision center or clinic
• ✓ Training sessions
• ✓ Community activities
• ✓ Team photos

Please submit 2–5 photos whenever possible

Length: 15–60 seconds

Suggested Content:

• ✓ Individual sharing their story
• ✓ Student discussing their training
• ✓ Faculty member discussing impact
• ✓ Eye care professional describing how training changed their work
• ✓ Footage of care being delivered
• ✓ Vision center activities

Video Guidelines:

• ✓ Good lighting
• ✓ Clear audio
• ✓ Stable camera
• ✓ Horizontal or vertical format