Abstract
Purpose: :
. The University of California, Los Angeles Mobile Eye Clinic (MEC) examines all first-graders in some of the elementary school districts in Southern California. The purpose of this research is to investigate the influence of demographic and academic factors as well as socioeconomic status (SES) on visual impairment (VI) among all screened first-graders in the Hawthorn and Rosemead elementary school districts between 2000 and 2003. While past research has investigated factors associated with VI, most studies used self-reported information regarding VI or included a relatively smaller number of children in the analyses. Limited research is available on environmental influences, such as school characteristics, on VI.
Methods: :
. The primary outcome variable was VI (uncorrected visual acuity worse than 20/40) in at least one eye. The academic performance index (API) for each school was obtained from the Department of Education. A Wilcoxon rank sum test was used to assess the differences in the median of the API between children with and without VI. The relationships of race/ethnicity, gender, SES, and API to VI were analyzed using logistic regression models.
Results: :
. Between 2000 and 2003, 3,529 first-graders were examined by the MEC in the two school districts. The majority (65.4% or 2,308) were Latino; 15.8% (559) were black; 16.4% (579) were Asian; and 2.4% (83) were Latino. The percentage of students with low SES in schools ranged from 70% to 92%. The API ranged from 638 to 793. A total of 336 children (9.5%) had visual acuity worse than 20/40 in at least one eye. Males tended to be slightly more likely than females to be visually impaired after adjustment for race, API, and SES [OR=1.228, 95% CI: 0.931-0.998, p=0.075]. Race and ethnicity were not significant predictors of VI although black children had the highest rate of VI. Approximately 10.4% of black children were visually impaired compared to 7.2% of white children. The median API score decreased as vision worsened (p=0.011). With every 10 point increase in the API, there was approximately a 3.6% decrease in the rate of VI [odds ratio: 0.964, 95% CI: 0.931-0.998, p=0.039] after adjustment for sex, race, and SES.