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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]

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 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]

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]

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]

Objective: School-based vision programs (SBVPs) connect children to eyecare directly in schools with benefits for vision and academics. Whereas parental engagement is critical to SBVP success, research on parent perspectives is lacking. We report on parental suggestions about how to maximize the impact of SBVPs. Methods: Data were collected from 20 parent focus groups (90 participants) in Baltimore, MD and Chicago, IL. Focus groups were recorded, audio-transcribed, and coded using inductive thematic analysis. Results: Major themes of parental suggestions for maximizing SBVP impact were: (1) communication, (2) education, and (3) eyeglass resources. Flyers and phone calls were the most frequently suggested methods for communication. Parents requested education regarding screening outcome, instructions for eyeglass use, and eyecare recommendations. Parents also suggested eyeglass resources to assist in maintenance and multiple pairs of eyeglasses. Conclusions: This information provides a framework about what parents want to know about SBVPs and opportunities to strengthen program-parent engagement. This framework can support the mission of increasing early childhood vision screening and reducing vision loss in children and adolescents as set forth by Healthy People 2030. [ABSTRACT FROM AUTHOR]

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]

Objective: School-based vision programs provide care directly in schools. Parental consent is typically required for student participation. In this paper, we examine school-level factors associated with consent form return. Methods: We included 123 schools served by a vision program in Baltimore, Maryland between the 2016-17 and 2018-19 school years. Multiple linear regression modeling was used to examine the associations between consent return rate and school type (elementary, elementary/middle or middle school), school size, student attendance, student mobility, percent of students in special education, poverty (percent eligible for free and reduced-price lunch), teacher qualifications, parent response rate to annual school climate survey, vision screening failure rate, and year of vision program participation (cohort). Results: The final model explained 26.2% of variability in consent return rate. Overall consent return rate was 57.8% (range 9.4%-100%). School size (β = -2.419, p < .01) and cohort (βCohort2 = 11.988, p < .01) were significantly associated with consent rate. Whereas poverty (β = 0.225, p < .10) and mobility (β = -0.647, p < .10) were relevant, they did not reach statistical significance. Conclusions: School-level factors are significantly associated with consent form return rates. School-based vision programs should consider additional measures to increase consent form return, especially in larger schools and schools with high rates of student mobility. [ABSTRACT FROM AUTHOR]