The day’s last rays bathe clusters of beds and lockers at the Division Circle Navigation Center in a warm golden hue. A small, white-and-brown dog appears, bounding after a ball as it bounces beside the beds, past the belongings tucked neatly underneath.
Inside a nearby office, co-coordinator and first-year medical student Ashwin Gadiraju, leads fellow students as they convert the room into half a dozen exam spaces for the night’s monthly eye clinic. In a small open-air courtyard, fellow first-year UC San Francisco medical student and clinic coordinator Andy T. Nguyễn tapes eye-test charts to a wall.
Motorists on the highway overpass above might never notice the Division Circle shelter if not for its tented teardrop shaped roof — a hallmark of many San Francisco navigation centers catering to some of the city’s more than 8,000 homeless residents. Opened in 2018 and run by St. Vincent de Paul Society of San Francisco, the 186-bed facility was designed as temporary housing, but some guests stay up to three years, given the dearth of affordable housing.
UCSF’s Benioff Homelessness and Housing Initiative research shows that high housing costs keep many low-income Californians — particularly older adults — teetering on the brink of homelessness.
For nearly as long as the Division Circle shelter has been in operation, UCSF medical students, residents, and physicians have provided basic eye care to hundreds of city residents experiencing homelessness. Under faculty supervision, the student-run ophthalmology clinic sees dozens of patients annually. About two-thirds receive full eye exams, including evaluations needed to replace lost or stolen glasses — for which the clinic ensures free replacements. A similar number require follow-up treatment for conditions like cataracts or diabetes and are referred to the Priscilla Chan and Mark Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG).
“When you’re unhoused, you spend a lot of time in lines — lines for housing, lines for food, lines for public benefits,” St Vincent de Paul’s Program Director David Albizo explains. “It’s day in and day out — and it’s frustrating.”
He continues: “We want to bring comprehensive services to our guests — and we’re grateful for the times UCSF can come in and bring that care to them … and we know that it’s going to be with a lot of empathy, caring, and compassion.”
The Division Circle clinic was founded in part by UCSF Ophthalmology Professor Alejandra de Alba Campomanes, MD, MPH, the Deborah Hoyt and Creig S. Hoyt, MD, Chair in Pediatric Ophthalmology. UCSF medical students and alumni have been behind some of California’s most iconic community clinics, from the city’s Haight Ashbury Free Clinic, which transformed addiction care, to Sacramento’s Clínica Tepati and Oakland’s La Clínica de La Raza that filled critical gaps in immigrant care. Student-run clinics like these help care for Californians and provide learners and residents with real-world training that prepares them to practice in communities across the country, from Alaska to Florida.
Eyeball rabbit hole
In the Division Circle shelter courtyard, UCSF medical students fan out among the waiting crowd and begin conducting basic eye screenings.
“Do you have any problems or concerns with your vision?” they ask, reading from a clinic intake form developed by student coordinators, including Nguyễn and Gadiraju — with help from UCSF medical residents, optometrists, and ophthalmologists. The document includes practical guidance and Spanish translations to help learners take medical histories and conduct basic vision screening.
Nguyễn likes to say he fell down the “ophthalmology rabbit hole” after working as an ophthalmic technician shortly after high school. “I’ve been in love with eyeballs ever since.” But for many other medical students, tonight’s clinic is their first exposure to “the world of eyeballs.”
“One of the things that makes our clinic special is the amount of one-on-one time medical students get with their patients,” Gadiraju explains. “Students don’t just observe; they listen to each guest’s experiences and the barriers they face in their communities, all while developing hands-on clinical skills in a supervised setting.”
A tall blond man in a navy polo shirt appears. His vision is fine with corrective lenses, he assures Nguyễn. But he’s lost them, and cheap reading glasses aren’t cutting it. Now, to get a driver’s license, he’ll need new eyewear — and a written report from an eye doctor stating that he meets vision requirements to drive with corrective lenses.
“I just need to renew my license,” he tells Nguyễn.
Better? Worse?
About an hour later, the medical students have completed the basic screenings, and shelter residents have wandered off to relax in the dorms or in the center’s large common room. UCSF ophthalmologists, optometrists, and ophthalmology residents — physicians who are training to specialize in eye care — arrive.
The medical students present their patient cases, gleaned from the screenings, to physicians and specialists. Physicians triage which shelter guests need to be called back for full exams.
Students and volunteers round up the patients and guide them back to the makeshift clinic, among them is the man in the navy polo shirt.
Suddenly, the room is abuzz. In one corner, a young man is examined for dry eyes, while an older man has his eye pressure checked. Ophthalmology Resident Shreya Shah, MD, MBA, helps medical student Seleipiri Charles-Norfleet position a mobile scope to peer into another guest’s dilated eyes.
Across the room, UCSF optometrist Olivia Bass, OD, fits lenses for an elderly woman.
“Better — or worse?” asks Bass, placing a new lens before the woman. Students translate her query into Chinese.
“Worse, worse,” the woman suddenly exclaims, giggling. Bass, smiling, switches the lens.
New glasses, new opportunities
Ophthalmology Resident Jacqueline Lopez, MD, helps connect shelter patients to follow-up care at ZSFG, which can include everything from referral letters to mapping bus routes to the county hospital.
“We’re more than happy to see patients over at the hospital eye clinic, but — because of transportation issues — some patients can’t always get to us,” she says. “It’s really valuable for us to be able to meet them here, where they are, and plug them into the health care system.”
Across the room, UCSF ophthalmology fellow Rebecca Tanenbaum, MD, examines the man in the navy polo shirt and reassures him that he qualifies to renew his license with corrective lenses.
He’ll also receive new glasses.
Offering eye exams may seem simple. But, for some clients, like the man with the polo shirt, new glasses can mean a driver’s license, a chance to land a job, housing, and even schooling.
“We had one guest who was able to get an eye test for a driver’s license through the clinic and he’s now driving a taxi,” Albizo remembers.
For Gadiraju, the clinic gives him the chance to go out into the community and talk to people while practicing clinical skills.
“I came in not really knowing what I wanted to do within medicine,” he says. “Through this experience, I’ve come to appreciate the immense power of vision care in restoring patients' independence and quality of life."
UCSF’s Ophthalmology Department is among the nation’s top 10 eye care programs, according to the 2025–26 U.S. News & World Report Best Hospitals rankings. The nationally recognized residency program offers advanced surgical training, which is available at fewer than 20% of ophthalmology residencies nationally. The department holds one of only three prestigious National Institutes of Health grants for ophthalmology residency research training.