Abstract
Purpose: :
Having uncorrected refractive error (URE) may decrease the academic achievement of children. This study determined the prevalence of and factors associated with URE among children in the first-grade, a critical period of academic development that has been shown to impact long-term scholastic performance.
Methods: :
The UCLA Mobile Eye Clinic (MEC) offered eye examinations to 87% of all first-graders in six schools located in the Santa Monica-Malibu Unified School District in Southern California between the 2000-2001 and 2005-2006 academic years. URE was defined as the lack of eyeglasses for the treatment of myopia (at least -0.75 dioptre (D) in each principal meridian), hyperopia (at least +1.25Ds in each principal meridian), or astigmatism (1-D difference between the two meridians) on the day of the eye exam.
Results: :
Among the 2,286 first-graders who were examined, 980 (42.9%) were Latino, 691 (30.2%) were White, 179 (7.8%) were African American, 146 (6.4%) were Asian/Pacific Islander, and 290 (12.7%) were from another racial/ethnic group or did not report their race/ethnicity. Of the 2,286 children, 210 (9.2%) had refractive errors that required the use of eyeglasses. Among these 210 children, 172 (82.1%) had URE; the highest percentage of URE was among African American children (94.4%), followed by Latino (85.8%), Asian/Pacific Islander (75%), and White (70.5%) children. When adjusting for gender, age, school, and academic year, African American children tended to be more likely to have URE compared to White children (Odds Ratio (OR)=7.35, Confidence Interval (CI): 0.77-70.10, p-value (p)=0.083). Children attending two schools located in low socioeconomic status areas were more than four times as likely to have URE compared to those attending a school situated in an affluent area, after controlling for race/ethnicity, gender, age, and academic year (OR=4.35, CI: 1.47-12.88, p=0.008). The odds of having URE tended to decrease with increasing age in these first-graders aged between 5 and 7 years (OR=0.48, CI: 0.23-1.00, p=0.050).
Conclusions: :
Among first-graders who received required vision screening by a school nurse in the previous year, a high percentage of children, especially African American/Latino children and those in poor areas, who needed eyeglasses did not have or wear them. Future research should investigate what interventions would help decrease the rates of URE among first-graders who are in the process of becoming more dependent on their vision to perform school work.
Keywords: refraction • myopia • hyperopia