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To investigate the relationship between neighbourhood disadvantage and vision screening failure rates. This analysis uses aggregate data from pre-kindergarten to eighth grade schools participating in a school-based vision programme in Baltimore, Maryland, from 2016 to 2019. Data on number of students screened and number of students who failed vision screening per grade level were recorded for each school. The Area Deprivation Index (ADI) was obtained for each school using the school's ZIP+4 code. The association between vision screening failure rates by grade and school ADI was analysed using negative binomial regression models, adjusted for grade level and accounting for clustering by school. Nine hundred seventy-two grades across 117 schools were included in this analysis. Median national ADI percentile across the sample was 71 [interquartile range (IQR): 48–85] (100 = most deprived). The median grade-level screening failure rate across the entire sample was 33% [IQR: 26–41%]. School ADI was not associated with vision screening failure rate (incidence rate ratio (IRR) = 1.01 per 10 percentage point increase in ADI, 95% CI: 0.99, 1.03, p = 0.217). In this study, there was no association between vision screening failure rates and school ADI. With one in three students failing screening in a high poverty public school district, these findings suggest a high need for vision services across schools in all neighbourhoods. Future work should investigate the impact of students' home ADI and socioeconomic status on vision screening outcomes. [ABSTRACT FROM AUTHOR]

The academic, socioemotional, and health impacts of school policies throughout the COVID-19 pandemic have been a source of many questions that require accurate information about the extent of onsite schooling occurring. This article investigates school operational status datasets during the pandemic, comparing (1) self-report data collected nationally on the household level through a Facebook-based survey, (2) county-level school policy data, and (3) a school-level closure status dataset based on phone GPS tracking. The percentage of any onsite instruction within states and counties are compared across datasets from December 2020 to May 2021. Sources were relatively consistent at the state level and for large counties, but key differences were revealed between units of measurement, showing differences between policy and household decisions surrounding children's schooling experiences. The consistency levels across sources support the usage of each of the school policy sources to answer questions about the educational experiences, factors, and impacts related to K-12 education across the nation during the pandemic, but it remains vital to think critically as to which unit of measurement is most relevant to targeted research questions. [ABSTRACT FROM AUTHOR]

To report refractive error findings in Baltimore City schoolchildren who failed school-based vision screenings. In this cross-sectional analysis, students pre-kindergarten through 8th grade who failed screenings during school years 2016–2019 received an eye examination, including non-cycloplegic autorefraction and visual acuity (VA) measurements. Refractive error was identified when there was at least: −0.50 diopter (D) spherical equivalent (SE) myopia, +0.50D SE hyperopia, 1.00D astigmatism, or 1.00D anisometropia in either eye. Generalized estimating equation models were used to identify factors associated with clinically significant refractive error, defined as decreased VA and more severe refractive error. Of 7520 students who failed screening, 6627 (88%) were analyzed. Clinically significant refractive error and any refractive error were found in 2352 (35.5%) and 5952 (89.8%) students, respectively. Mild myopia (45%, −0.50 D to <-3.00 D SE) and low astigmatism (47%, 1.00 D to <3.00 D cylinder) were the most prevalent types of refractive error. Proportions of students with myopia increased with higher grade levels (Ptrend<0.001). Myopia and astigmatism were more common in black and Latinx. Risk factors for clinically significant refractive error included higher grades (odds ratios [OR] ranged from 1.30 to 2.19 compared with 1st grade, P <.05) and Latinx ethnicity (OR = 1.31, 95%CI: 1.08–1.59). A Baltimore school-based vision program identified a substantial number of students with refractive error in a high-poverty urban community. Over 1/3 students who failed vision screening had clinically significant refractive error, with black and Latinx students at higher risk of having myopia and astigmatism. [ABSTRACT FROM AUTHOR]

To explore stakeholders' perceptions of a school-based vision programme (SBVP). We conducted 20 focus groups with 105 parents and teachers at schools in Baltimore, MD, that participated in a SBVP. Facilitators used a semi-structured interview guide to discuss participants' perceptions of the SBVP. Focus groups were audio-recorded, transcribed, and coded using inductive thematic analysis. Participant perceptions fell into three categories: benefits of school-based eye care, limitations of school-based eye care, and observation of impact. The majority of participants had positive comments about the programme; benefits included convenience (location, time, and cost), the comprehensive nature of the programme, the quality of the eyeglasses and ability to receive replacements, and a positive screening/exam experience. Limitations of programme impact were related to communication and organisation, the time to receive the glasses, missed instructional time, and uncertainty about screenings. Observations of impact included academic and classroom improvements, as well as visual and other health improvements. Parents and teachers reported mostly positive perceptions regarding the SBVP. Their appreciation for the convenience underscores that location, cost, time, and comprehensive services are crucial aspects for implementing a successful programme. To maximize impact, programs must also implement robust communication campaigns that integrate into the schools' workflow to help parents and teachers stay engaged in the process from start to finish. [ABSTRACT FROM AUTHOR]

Methods During March 2021, we searched each state Departments of Education and Health websites to systematically collect the following: (1) information about state-mandated VS during the 2020-2021 academic cycle amid the COVID-19 pandemic and (2) guidance about VS missed during the academic year 2019-2020 due to COVID-19-related school closures. Results As of March 2021, 16 states had publicly available information from their state Department of Health or Education about VS requirements for the 2020-2021 academic year. Vision screenings (VS) are an important public health tool to detect children at risk for vision problems.[1] Early identification and treatment result in better long-term visual and academic outcomes.[2] In the United States, 39 states and the District of Columbia require VS for school-age children.[3] Often, school nurses or other trained staff conduct VS within the school setting. [Extracted from the article]

To compare the vision needs of children wearing and not wearing eyeglasses who failed school-based vision screening. Students aged 4 to 16 years in 41 Baltimore City schools were screened using distance visual acuity (VA) and photoscreening. Students failing screening underwent school-based non-cycloplegic examination. We compared students who were wearing eyeglasses at failed screening with those not wearing eyeglasses with respect to age, sex, right-eye refractive error, right-eye presenting, and best-corrected VA (BCVA). A total of 2176 students failed screening and completed the examination; 94 (4.3%) failed while wearing eyeglasses. Students wearing eyeglasses were older (mean age 10.2 vs 8.8 years, p <.001). Myopia (72.3% vs 46.0%, p <.001), severe myopia, ≥6.00 spherical equivalent diopters (D) (9.6% vs 1.8%, p <.001), astigmatism (66.4% vs 50.8%, p =.004), and severe astigmatism, ≥3.00 D of cylinder (14.9% vs 7.0%, p =.008) were more common in students wearing eyeglasses. The prescription rate was higher for students wearing eyeglasses at failed screening compared with those not (95.7% vs 80.4%, p <.001). About 4% of the children in both groups required referral to community providers for non-refractive pathology, such as strabismus or amblyopia (p =.6). Children who fail vision screening while wearing eyeglasses nearly always needed an updated prescription and had more severe refractive errors than those not wearing eyeglasses. However, the community referral rate was the same for both groups. School-based programs can support children currently wearing eyeglasses that may be incorrect or outdated. [ABSTRACT FROM AUTHOR]

The purpose of this article is to compare alignment outcomes following pediatric strabismus surgery for simple horizontal strabismus in patients with state-based aid, used as a proxy for lower socioeconomic status (SES) with those with private insurance. Medical records of all children treated with horizontal strabismus surgery over a period from 2014-17 were retrospectively reviewed. Medical assistance was used as a proxy for lower SES. Patients were compared to a control population undergoing similar surgery by same surgeons in the same time period. Data points were collected at preoperative and postoperative month 6 visits. Improvement in alignment was the primary outcome variable. Improvement in fusion, amblyopia, and stereopsis were also examined. Demographic information and compliance with treatment recommendations were recorded. 69 patients met inclusion criteria from a total population of 105 patients; 36 were excluded due to loss to follow-up. This was compared to a control group with private insurance; 34 patients were identified out of a total of 38, 4 patients were lost to follow-up. Overall rate of operative success was 71.0% at POM6. Overall rate of success for control group was 73.5%. The difference failed to be statistically significant (p = 0.37). Race, sex, age at time of surgery, and type of strabismus (esotropia, exotropia) failed to correlate with success rate of surgery. Poor compliance with prescribed treatments (glasses, patching/atropine) in both groups correlated with surgical failure. 68.1% of study patients and 70.6% of control reported good compliance with treatment. We present the first analysis of the impact of SES on strabismus surgery outcomes. Overall surgical success rate in our study population failed to differ significantly from a control population and were comparable to that reported in the literature. We found that compliance with treatment influenced surgical success rates in our study population. The high rate of lost to follow-up in the study population is an important factor influencing our conclusion that no difference exists between our groups. [ABSTRACT FROM AUTHOR]

Aims: The objective of this study was to determine how occupational therapy practitioners use assistive technology (AT) when treating clients who have Alzheimer's disease and related dementia (ADRD). Methods: This study utilized a qualitative phenomenological approach in which occupational therapy practitioners were individually interviewed to explore their use of AT with clients who have ADRD. Results: Findings suggest that some assistive technology devices work better for clients at different stages. Clients in the earlier stages of dementia can use a broader range of assistive technology devices, while those in the later stages may not have the ability to use intricate assistive devices. It was also found that assistive technology is primarily used to address safety concerns with the ADRD population. These concerns include elopement, fall prevention, kitchen safety, and medication management. Three main themes were identified in the current study, including Education (for both the client and their family members/caregivers), Safety, and Selection Process. Conclusions: When using AT, occupational therapy practitioners must consider the stage of dementia their client is in, as well as the client's performance skills. Client safety and education were emphasized as key elements of the occupational therapy process. [ABSTRACT FROM AUTHOR]

Cavernous angiomas of the cranial nerves are extremely rare, and those of the oculomotor (third) cranial nerve are rarer still, with no previous cases having been reported in the literature. We report herein the first case of a presumed cavernous angioma involving the subarachnoid portion of the left third nerve presenting as an acute left third nerve palsy in an infant. The child was followed without intervention and the palsy completely resolved. Given the poor functional results with attempted surgical excision and the potential for spontaneous improvement in oculomotor nerve function, it is reasonable to follow patients with these lesions without intervention. [ABSTRACT FROM AUTHOR]

Many disadvantaged students with refractive errors, such as myopia (nearsightedness) and hyperopia (farsightedness), do not have eyeglasses, and their reduced vision may impact reading proficiency. Providing eyeglasses may increase their reading success. This article reports the findings of a study in Baltimore City in which disadvantaged second and third graders were assessed for vision problems. Of 317 students, 182 were given glasses. Those who needed glasses were given two pairs, one for home and one for school, as well as replacements if glasses were lost or broken. School staff assisted in ensuring that students wore their glasses, storing them safely, and replacing glasses when necessary. Students who received glasses improved more on Woodcock reading measures than those who never needed glasses (ES = +0.16, p <.03). The study demonstrates the potential of providing eyeglasses to disadvantaged students who need them to improve their reading performance. [ABSTRACT FROM AUTHOR]