GiveBetter x Atlanta

Georgia Lions Lighthouse Foundation

Vision care, with an Atlanta school-eyeglasses pathway modeled

Research time: ~8 min on GPT-6 Astra Light + ~2 min on GPT-6 Astra Low
  • Research — reviewed programs, finances and impact evidence.
  • Modeling — estimated costs, QALYs and uncertainty.
  • Source audit — checked claims, assumptions and calculations.

Updated: 2026-09-29

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Summary

What do they do? Georgia Lions Lighthouse Foundation provides eye examinations, prescription glasses and coordination of eye surgery for Georgians with limited access to care. Its Atlanta Public Schools partnership delivers exams and glasses at school, removing travel and payment barriers. It also serves people statewide and sends recycled glasses overseas; those activities receive no benefit credit in this narrow local model.

Why we’re interested in this organization:

  • The original report identifies 1,114 Atlanta Public Schools examination recipients and says all students needing corrective eyewear received it.

  • Original tax returns permit a three-year full-resource cost reconciliation including donated services and direct event costs.

  • Prescription correction has a direct vision-to-quality-of-life mechanism, supported by clinical evidence but not locally quantified.

Our main reservations:

  • The share needing glasses, local utility change, sustained wear and alternative-glasses counterfactual are not measured.

  • The conditional price is driven by explicit subjective assumptions and is not a prediction of health purchased by a gift.

  • Current unmet funding capacity is unverified, and inconsistencies in reported screening figures require clarification.

What do you get for your dollar? $10.6M per DALY in Atlanta. DALY is our one-year comparison unit. QALY-based health gains and income-welfare equivalents retain their original assumptions; they are not measured clinical DALYs. Conditional whole-recipient resource cost per 10 Atlanta-metro QALYs; not an expected gift price; donor HOLD.

FY2025 APS examination cohort: 1,114 students. Glasses reportedly fulfilled for those needing them; prescription-needed share is unknown. Statewide 207 surgical patients / 421 procedures excluded. Screenings and recycled shipments are not health outcomes.

1. What do they do?

The recipient is Georgia Lions Lighthouse Foundation, Inc., EIN58-0548732. It operates the Harrell Vision Clinic in Chamblee, mobile and tele-optometry clinics, prescription-glasses services and a statewide surgical referral network. Eligibility targets uninsured or underinsured people in financial need; some optical services carry low fees. Current service listings and2026 school-glasses news support continuing delivery. Services Current news

2. Monitoring and information sharing

The original FY 2025 report's Atlanta Public Schools page identifies 1,114 students receiving complete eye examinations and says prescription glasses were distributed with full fulfillment for students needing corrective eyewear. This does not unambiguously establish that all 1,114 received glasses. The model therefore starts with examination recipients and explicitly assumes a prescription-needed share. No screenings are converted to restored sight. [Original report, pages 5–6](https://lionslighthouse.aflip.in/fy 25 impactreport)

The same report describes 207 surgery patients receiving 421 procedures across several diseases; those are not 421 people or 207 cataract patients. The original Form 990 corroborates the surgery counts. No surgery, statewide optical or overseas recycling benefit is added. The school page's screening count and claimed 64.28% growth require reconciliation with prior-year reporting. Neither year's screenings are added to the examination cohort. Deduplication, prescription severity, actual wear and outcomes lack independent audit.

3. Qualitative assessment

School delivery can remove transport and financial barriers, but provision does not guarantee sustained use or an incremental improvement over glasses that families or other charities would supply. A randomized Indian school study observed roughly three-quarter wear at short follow-up in both ready-made and custom-glasses groups; it did not compare glasses with no glasses or measure Atlanta utility. Primary wear trial

A Singapore cross-sectional study of699 myopic teenagers found time-tradeoff utility about0.94 in corrected versus0.92 in uncorrected students after race/sex adjustment. This association is neither a causal treatment effect nor a transferable estimate for younger Atlanta children. The model's0.01 utility increment is explicitly an analyst judgment, not the study result divided by two as a validated estimator. Primary utility study

First-eye cataract surgery has randomized evidence of improved vision and health status, but the foundation's local cataract cohort and disease mix are unknown. One family testimonial cannot identify aggregate local impact; it names the sister's Paulding residence, not conclusively the patient's residence. That pathway is left unmodeled. Primary cataract trial

The wear trial measured use at 3–4 months among followed participants, with about 21% lost to follow-up; it cannot establish six-month sustained wear in Atlanta. The utility study elicited willingness to trade life for removal of myopia, not a randomized glasses-induced change in generic health utility. Its standard-gamble result did not show the same correction association. Thus 0.01 is a scenario choice, with zero also plausible. Prescription share, alternative access and funding response have no calibrated local priors; their product and independence are unvalidated.

4. What do you get for your dollar?

The conditional central is approximately $106.29 million per 10 Atlanta-metro QALYs: $3,700,076 of FY 2025 recipient resources divided by 0.348125 modeled metro QALY and multiplied by 10. This is a weak-confidence assumption exercise, not measured cost-effectiveness, a posterior expected value or an expected marginal gift price.

The bridge is 1,114 examined students × 50% needing and receiving prescription glasses × 50% effective wear × 50% incremental correction beyond alternative access × 50% funding response × 0.01 utility × 0.5 year × 100% metro attribution. The prescription share is an explicit uncalibrated assumption: full fulfillment among those needing glasses does not establish the fraction needing them. Only examination count and accounting inputs are observed. Metro attribution is inferred from school enrollment, not verified addresses. No lifetime, mortality or learning-income credit is used. Other portfolio net health is provisionally zero, not proven harmless.

The weak and favorable combinations produce about $4B and $295K per DALY; these are not confidence limits. Zero prescription need, wear, additionality or funding response yields zero modeled health and no finite price. Net harm is also considered. The three-year reconstructed resource mean is $3,474,317.67; FY 2025 cost matches the activity period.

Model, assumptions and sensitivity

FY 2025 entire recipient reconstructed resources: tax functional expenses+recognized donated services+direct event costs excluded from PartIX. Includes investment management; not societal partner costs outside these accounts.

Modeled cohort is Atlanta Public Schools;100%metro is an explicit enrollment-based inference, not patient residence audit. Statewide and overseas services receive zero positive credit.

C=2617279+892628+190169=3700076; Q_all=N*p*w*a*f*u*T-H; Q_metro=N*p*w*a*f*u*T*g-H; price=10*C/Q_metro only if positive. Central N=1114,p=.5,w=.5,a=.5,f=.5,u=.01,T=.5,g=1,H=0.

C: full-recipient resources
3700076 USD/FY 2025 (observed). Calculated from original tax functional expenses2617279+donated services892628+direct event expenses190169. [return25] [d25]
N: APS examination cohort
1114 reported examined students (observed). Original report p5 identifies examination recipients; it does not unambiguously identify the number needing glasses. [annual25]
p: prescription-needed and fulfilled share
0.5 fraction of examined students (judgment). Unknown locally. One-half is an uncalibrated conditional scenario, not inferred from 100% fulfillment among those needing correction. Sensitivity spans zero to one. [annual25]
w: effective wear fraction
0.5 fraction (judgment). Allows nonwear, poor fit, breakage and lack of sustained use; external short-term wear trial does not estimate this local rate. [wear]
a: incremental correction versus alternatives
0.5 fraction (judgment). Half the correction is assumed not to occur as soon via family or other providers; no local control group.
f: funding-response prior
0.5 fraction (judgment). Hypothetical responsiveness, not verified marginal room. Existing sponsor funding and partner capacity could fully replace new gifts. [annual25]
u: utility improvement while effectively corrected
0.01 QALY per year (judgment). Explicit small utility judgment. Singapore cross-sectional association is context, not a causal calibration. [utility]
T: effective benefit horizon
0.5 year (judgment). No credit beyond six months, allowing prescription change, replacement and alternative access. No lifetime or mortality benefit.
g: metro attribution
1 fraction (judgment). Enrollment in Atlanta Public Schools strongly anchors metro delivery; beneficiary addresses not audited. [annual25]
H: other net adverse health
0.00 metro QALYs (judgment). Zero only in central; omitted portfolio is not assumed beneficial or harmless.
Verified additional gift capacity
null additional services/USD (unknown). Appeals and giving menu do not establish current unfunded budget, waiting list or staff expansion. [annual25] [donate]

Conditional alpha central; donor HOLD: Cost: $3.7M; Atlanta health QALYs: 0.35; all-population health QALYs: 0.35. N is examined students; prescription-needed share p=0.5. 1114*.5 wear*.5 alternative-care adjustment*.5 funding response*.01 utility*.5 year*1 metro;H=0. All bridge factors judgmental, not measured QALYs or expected gift price.

Weak pathway combination: Cost: $3.7M; Atlanta health QALYs: 0.00; all-population health QALYs: 0.00. N is examined students; prescription-needed share p=0.1. N 1114,w.25,a.25,f.1,u.005,T.25,g.95,H 0. No probability assigned.

Favorable pathway combination: Cost: $3.7M; Atlanta health QALYs: 12.53; all-population health QALYs: 12.53. N is examined students; prescription-needed share p=1. N 1114,w.75,a.75,f 1,u.02,T 1,g 1,H 0. Not an upper confidence bound.

No incremental benefit: Cost: $3.7M; Atlanta health QALYs: 0.00; all-population health QALYs: 0.00. Setf=0 (orw=0 ora=0): no marginal response, no effective use or full alternative access.

Net adverse health stress test: Cost: $3.7M; Atlanta health QALYs: -1.00; all-population health QALYs: -1.00. Setf=0 andH=1; hypothetical net harm, not observed adverse event count.

No prescription-mediated benefit: Cost: $3.7M; Atlanta health QALYs: 0.00; all-population health QALYs: 0.00. p=0 (or u=0), so examinations produce no modeled prescription-mediated QALYs; this stress test is not a claim that nobody needed glasses.

Counterfactual: a discounts corrective eyewear obtained anyway from families, insurance, schools or alternative charities. f separately discounts capacity that would persist despite changed donor funding; neither is estimated.

Attribution: Whole recipient costs retained without allocation to schools. KIA and school partners contribute to observed provision; alternative delivery and funding replacement remain possible. No independent claim to all partnership benefit.

Accepted only as a weak-confidence conditional alpha. No empirical posterior or expected marginal gift estimate. All bridge factors, including prescription share, are uncalibrated judgments. Donor HOLD; not a top-pick endorsement.

Sensitivity

  • Prescription share 0.25 instead of 0.5 doubles price; 1 halves it; 0 eliminates finite price.
  • Utility 0.005 instead of 0.01 doubles price; 0.02 halves it; zero eliminates finite price.
  • Funding response 0.1 instead of 0.5 multiplies price by 5; zero eliminates finite price.
  • Joint weak/favorable combinations span $4B–$295K per DALY, not confidence bounds.
  • No benefit credited to surgery, screenings or overseas shipments.

Unresolved inputs

  • Actual fraction of examined APS students needing and receiving prescription glasses
  • Audited deduplicated APS glasses recipients and baseline refractive severity
  • Local wear, breakage, replacement and duration follow-up
  • Preference-based causal utility change for comparable children
  • Counterfactual alternative-glasses access
  • Current marginal funding gap, staffed capacity and gift restriction
  • Reconciliation of repeated screening count and growth claim
  • Surgery disease mix, outcomes and metro residence

5. Funding and previous grants

FY 2025 Form 990 functional expense is $2,617,279. Add $892,628 donated services from Schedule D and $190,169 direct fundraising-event costs netted against revenue in PartVIII to obtain $3,700,076. This retains program, administration, fundraising and investment-management costs. It does not add the separate $650,000 surgical donated-value claim again. The Schedule D audited-expense figure $3,374,979 reconciles by subtracting donated services and adding $134,928 investment expenses to reach the tax figure; it is not the same resource scope. [Original return](https://projects.propublica.org/nonprofits/full_text/202621349349310557/IRS 990) [Schedule D](https://projects.propublica.org/nonprofits/full_text/202621349349310557/IRS 990 Schedule D)

The same tax-expense-plus-donated-services-plus-direct-event-cost basis is $3,484,633 in FY 2023 and $3,238,244 in FY 2024. These are reconstructed resource costs, not a claim that standalone audit reports were retrieved. FY 2023's audited reconciliation already includes direct event costs; the reconstruction adds them only to the tax expense base, avoiding duplication. Original source files are retained for audit.

FY 2025 reports $22.42 million net assets, of which $15.61 million is donor restricted. A large balance is not proof of unrestricted cash or no funding need. The annual appeal seeks a full-time optometrist, but an appeal and historic matching offer do not verify today's unmet capacity. The official website links a live campaign whose HTML identifies this foundation as recipient; payment flow and any Atlanta restriction were not verified, and no payment was made. [Official campaign](https://www.classy.org/campaign/give-the-gift-of-clear-sight-2025/c 650490) Donor decision: HOLD pending an additional-capacity budget and gift allocation.

Annual expenses

Organization-level spending, including programs, administration and fundraising. The research list averages three comparable, consecutive full fiscal years when available.

  • FY 2023: $3.5M; Georgia Lions Lighthouse Foundation, Inc., 12-month period, Reconstructed total resources: tax functional expense + donated services + direct fundraising-event costs. Source
  • FY 2024: $3.2M; Georgia Lions Lighthouse Foundation, Inc., 12-month period, Reconstructed total resources: tax functional expense + donated services + direct fundraising-event costs. Source
  • FY 2025: $3.7M; Georgia Lions Lighthouse Foundation, Inc., 12-month period, Reconstructed total resources: tax functional expense + donated services + direct fundraising-event costs. Source

6. Sources

  1. FY 2025 impact report, original PDF pages 5–6. Georgia Lions Lighthouse Foundation. Published: not stated; retrieved: 2026-09-29.
  2. FY 2025 original Form 990 reconstructed from IRS filing. Georgia Lions Lighthouse Foundation / IRS. Published: not stated; retrieved: 2026-09-29.
  3. FY 2025 original Form 990 Schedule D. Georgia Lions Lighthouse Foundation / IRS. Published: not stated; retrieved: 2026-09-29.
  4. FY 2024 original Form 990. Georgia Lions Lighthouse Foundation / IRS. Published: not stated; retrieved: 2026-09-29.
  5. FY 2024 original Form 990 Schedule D. Georgia Lions Lighthouse Foundation / IRS. Published: not stated; retrieved: 2026-09-29.
  6. FY 2023 original Form 990. Georgia Lions Lighthouse Foundation / IRS. Published: not stated; retrieved: 2026-09-29.
  7. FY 2023 original Form 990 Schedule D. Georgia Lions Lighthouse Foundation / IRS. Published: not stated; retrieved: 2026-09-29.
  8. Current vision services. Georgia Lions Lighthouse Foundation. Published: not stated; retrieved: 2026-09-29.
  9. Officially linked Give the Gift of Clear Sight campaign. Georgia Lions Lighthouse Foundation / GoFundMe Pro. Published: not stated; retrieved: 2026-09-29.
  10. Utility values and myopia in teenage school students. Saw et al., British Journal of Ophthalmology. Published: not stated; retrieved: 2026-09-29.
  11. Spectacle wear among children in a school-based program: randomized trial. Morjaria et al., JAMA Ophthalmology. Published: not stated; retrieved: 2026-09-29.
  12. First-eye cataract surgery randomized trial. Harwood et al., British Journal of Ophthalmology. Published: not stated; retrieved: 2026-09-29.
  13. FY 2024 impact report. Georgia Lions Lighthouse Foundation. Published: not stated; retrieved: 2026-09-29.
  14. Current news, including May 2026 delivered school glasses. Georgia Lions Lighthouse Foundation. Published: not stated; retrieved: 2026-09-29.