Spectacle correction and reading ability in a school-based vision study in inner-city Baltimore.

Abstract

Purpose : Results from the Baltimore Reading and Eye Disease Study (BREDS) suggested uncorrected hyperopia is associated with reading difficulty for some children. Given that reading proficiency has been shown to be important for academic achievement, understanding the efficacy and feasibility of school-based eye exams and eyeglass distribution to correct hyperopia could be essential to future interventions.

Methods : Second and third grade students at 12 Baltimore City public schools underwent baseline and follow up vision and educational assessments between 2014 and 2016. The baseline eye exam included a cycloplegic refraction, and eyeglasses were prescribed to children with 1.00D or more hyperopia, 0.50D or more myopia, or 1.50D or more astigmatism. Participants were given 2 pairs of eyeglasses (one for home and one for school), and replacements were provided when needed. A battery of educational testing included Woodcock-Johnson III Tests, receptive vocabulary tests and Gray Oral reading assessment were performed.

Results : 317 students were enrolled with mean age of 7.9 years; 84% were self-identified as African American. American Academy of Ophthalmology criteria for eyeglass prescription were met by 21.8%, however only 6.8% wore glasses at baseline. 209 students were given eyeglasses based on study protocol; almost 60% needed at least one pair replaced and 20% needed 2 or more replaced. Mean near visual acuity improved from 0.1 logMAR at baseline to 0.01 logMAR at follow up. Early reading standardized z scores also improved by 0.16 (p<0.05) in students who received eyeglasses as part of BREDS compared to those with normal vision at baseline.

Conclusions : More than half of the students who needed spectacle correction per practice guidelines did not have them at baseline. Despite high rates of eyeglass loss or breakage, BREDS was able to improve near visual acuity and reading scores by conducting eye exams and eyeglass distributions at school. Future studies could evaluate approaches to increase eyeglass retention and use at school to ensure the benefit of spectacle correction is fully gained.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.