Abstract
Purpose :
Some students fail school-based vision screening despite wearing eyeglasses at the time of screening. We explore the demographic, visual and refractive characteristics of these students and compare them to students failing screening who were not wearing eyeglasses.
Methods :
During 2016/17 school year, students in 41 schools in Baltimore City were screened using distance acuity and photoscreener. We examined students who failed screening. We compared eyeglass wearers to non-wearers using Fisher’s exact test for categorical variables, Mann-Whitney U test for continuous variables, and log-binomial or Poisson with robust variance regression for multivariable associations.
Results :
2584 students failed screening and their guardians consented for them to be in the study, 114 of whom wore eyeglasses at the time of screening. Older children (p < 0.001) and girls (Prevalence Ratio (PrR) = 1.4, p = 0.02) were more likely to be wearing glasses at screening. Eyeglass wearers were less likely to fail the photoscreener (PrR = 0.8, p = 0.003), more likely to need a new prescription (PrR = 1.2, p < 0.001) and had similar presenting acuity to non-wearers (p = 0.3). After adjusting for age and sex, compared with eyeglass non-wearers, wearers were more likely to have any myopia (PrR = 1.3, p < 0.001), as well as moderate (PrR = 4.2, p < 0.001) and severe myopia (PrR = 4.3, p < 0.001); to have equal rates of hyperopia overall (PrR = 0.9, p = 0.7), but more likely to have moderate hyperopia (PrR = 2, p = 0.02); more likely to have astigmatism (PrR = 1.4, p < 0.001), especially high astigmatism (PrR = 2.4, p < 0.001); and more likely to be anisometropic (PrR = 1.4, p = 0.02). Best-corrected visual acuity was not different between the two groups (p = 0.8).
Conclusions :
Students wearing eyeglasses at the time of screening are less likely to fail the photoscreener testing, and had similar presenting acuities. However, when subsequently examined, they were more likely to be prescribed new glasses. While school-based programs are helping detect children unaware of vision problems, they are also critical for children with known refractive errors to provide updated prescriptions and refer to care when needed.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.