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Disparities in access to pediatric vision care for school-age children remain a pressing issue in the United States. School-based vision programs (SBVPs) are regarded as a means to advance health equity, especially for disadvantaged students. While SBVPs can be beneficial, these programs are only part of the solution. Interdisciplinary collaborations are needed to strengthen the pediatric eye care delivery system and advocate for broader access to needed eye services. This discussion will frame the role of SBVPs in conjunction with research, advocacy, community engagement, and medical education to advance health equity in pediatric eye care. [ABSTRACT FROM AUTHOR]

BACKGROUND: In 2012, Chicago Public Schools and the Chicago Department of Public Health partnered together to create the Chicago School‐Based Vision Program (CSBVP). This ongoing, city‐wide program provides school‐based vision services (eye examinations, eyeglasses provision, and eye care referrals) to students with limited access. METHODS: Descriptive analysis of the program operations from 2012 to 2020, including number of students served and exam findings during 2017‐2020, as well as lessons learned and recommendations for reproducing the successes of the CSBVP in other contexts. RESULTS: During its first 8 years, the CSBVP provided eye examinations to over 350,000 students. During the years 2017‐2020, this included 126,238 eye exams and provision of eyeglasses to 73,751 students. CONCLUSIONS: The CSBVP is built upon strong community and school relationships. The program offers vision services, equitably, to all students across the district. The lessons learned through the implementation of the CSBVP may provide guidance for future district‐wide vision programs. [ABSTRACT FROM AUTHOR]

Pediatric vision screening detects children at risk for visual conditions with the goal of connecting those in need with an eye care provider for evaluation and treatment. The primary aim for vision screening in younger children is the detection of those at risk for amblyopia, which can result in irreversible vision loss if left untreated. In older children, screening goals broaden to include the detection of risk for uncorrected refractive error. In the United States, professional organization guidelines and state-mandated requirements for vision screening vary widely across both the timing and components of screening. In this article, we describe the goals and components of pediatric vision screenings, current challenges, novel approaches to providing follow-up services through school-based vision programs, and future directions. [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]

Approximately 25% of school-aged children in the United States have vision abnormalities, most commonly refractive error that can be corrected with spectacles. Limited follow-up adherence after failed school-based vision screening led to an increase in school-based eye care programs that provide screening, eye examinations, and spectacle prescription at the school. These programs address the access barrier and often provide the first point of contact between children and eye care. Nevertheless, several lower prevalence conditions, such as amblyopia, strabismus, and glaucoma, cannot be adequately treated in the school setting, and some require frequent and long-term follow-up, necessitating referral to eye care providers in the community. We conducted a literature review and identified 10 programs that provided school-based screening, examinations, and spectacle prescription and reviewed their referral rates, criteria, mechanisms, adherence, ocular findings at referral, and long-term care plans. Most programs referred 1% to 5% of screened children. Most communicated with parents or guardians through referral letters and used various strategies to incentivize adherence. Referral adherence was 20-50% in the four programs that reported these data. School-based eye care programs rarely referred children for long-term follow-up care needs, such as updating spectacle prescriptions annually. [ABSTRACT FROM AUTHOR]

Vision screening and regular eye care can help detect and treat potentially irreversible vision impairment. This study aims to investigate the associations between sociodemographic and health characteristics and the receipt of eye care among children aged 17 years and younger in the United States. This cross-sectional study used data from the National Survey of Children's Health (NSCH), a nationally representative and population-based survey of randomly sampled households. Participants were children aged 0 to 17 years, residing in all 50 states and the District of Columbia, whose caregivers or parents answered an address-based survey by mail or online. Weighted prevalence calculations were applied to analyze the data, and logistic regression was performed to explore associations between reported eye care and demographic, health, and parent-related variables. Caregiver-reported vision screenings, referral to an eye doctor after vision screening, eye doctor visits, and prescription of corrective lenses. Caregivers reported that 53.2% of children had a vision screening at least once (if child ≤ 5 years) or within the past 2 years (if child > 5 years). Of those screened, 26.9% were referred to an eye doctor. Overall, 38.6% of all children had a previous eye doctor visit, and among them, 55.4% were prescribed corrective lenses during the visit. Factors associated with decreased odds of vision screening included younger age, lack of health care visits, no insurance coverage, parent education high school or less, and lower household income. Non-White ethnicities, households with a non-English primary language, and lower incomes were more likely to be referred to an eye doctor after vision screening. Lower rates of eye doctor visits were associated with younger age, lack of insurance coverage, and primary household languages other than English. Children from disadvantaged backgrounds are less likely to receive vision screening and eye care. Targeted strategies are needed to increase vision screening and access to eye care services in these vulnerable groups. Proprietary or commercial disclosure may be found after the references. [ABSTRACT FROM AUTHOR]

Vision screenings aim to identify students with possible vision problems. As part of a Baltimore school-based vision care program, screenings were conducted for all students, including those in state-mandated grades and nonmandated grades (2-7), in 82 schools. From 2016-18, 32650 pre-K to 8th grade students from Baltimore schools underwent vision screenings (distance acuity, Spot photoscreener, stereopsis, and alignment) by Health Department staff. [Extracted from the article]