Technique: The soft, comicstrip-esque art style works with the content well and gives the image a subtle, extra layer of playfulness that adds to it's impact.
Vision: The humor is inherent in the content and delivered with a subtly that fits with the series. (By that, I should say that the picture and the series it's based on has a 'Loony Tunes' ability to be both 'sledgehammer' and subtle simultaneously.) A strabimus eye doctor for the direct impact, but having her use rebuses for her eye chart is supremely slick in the exicution.
Originality: I can honestly state that this is the first time I have encountered the compesition you have created
Impact: Being a lady who has spent most of her life visiting eye doctors, this is a beautiful and touching image that makes me both laugh and sticks with me.