Abstract
Purpose :
To report vision screening and eye exam findings for the first 3 years of Vision for Baltimore, a school-based vision program serving public schools in Baltimore City. All participating schools qualified for free and reduced lunch.
Methods :
From 2016-19, pre-kindergarten through grade 8 students underwent vision screening (distance acuity, photoscreener (Welch Allyn Spot Vision Screener), stereopsis, and alignment). Students who failed any component, and whose guardians returned consent forms, were examined by an optometrist in a mobile vision clinic that came to the school. Students were prescribed and provided glasses, if needed. Refractive profile was determined by non-cycloplegic autorefraction (Tomey RC 5000), with myopia defined as spherical equivalent (SE) <-0.5 diopter(D), hyperopia as SE> 0.5D, and astigmatism as cylinder> 1.0D.
Results :
Of 51,593 students in 123 schools who were screened, 17,414 (33.8%) failed and were offered a school-based eye exam. Screening failure rates generally increased modestly with grade level (range 27-39%), with a statistically higherfailure rate in grades not mandated to have vision screening in Maryland.
Among the 7,525 students who provided consent for the exam, mean age was 9.0 ±2.8 years and 3,901 (51.8%) were girls. Screening failure was due to reduced VA (5,304, 70.5%) Spot (514, 60%), and other reasons (198,2.6%). 2491 (33.1%) failed both VA and spot, and 398 (5.3%) failed screening despite wearing glasses. A total of 6,680 (88.8%) completed the school-based eye exam, where 3,671 (55%) had myopia, 1,792 (26.8%) had hyperopia and 3,856 (57.7%) had astigmatism. With correction, 3,712/4,852 (76.5%) were logMAR 0.1 (20/25) or better in the worse-seeing eye. Among examined students, 5,002 (74.9%) received eyeglasses and 174 (2.6%) required referral to care in the community.
Conclusions :
One third of students in Baltimore City public schools failed vision screening, with higher failure rates in grades not mandated to have vision screening in Maryland. Approximately 75% of students examined required eyeglasses and only 3% were referred. Reduced visual acuity was the primary reason for screening failure; the majority of these students were corrected to 20/25 or better with the provision of glasses. School-based programs can address pediatric vision needs in high poverty urban communities.
This is a 2020 ARVO Annual Meeting abstract.