Abstract
Purpose :
Pediatric visual impairment is a significant public health issue especially impacting those from disadvantaged backgrounds. To address an increasing need and a decreasing prevalence of pediatric vision screening in the US, school-based vision screening programs have been developed to screen and refer children in need of ophthalmic care. Here, we assessed ocular diagnoses and refractive status of low-income children examined by a vision screening initiative in Rochester, New York, USA.
Methods :
Children from 6 schools from one high poverty urban and one suburban school district were assessed. Children who did not pass their visual acuity screening were offered an eye exam in their schools and follow-up to a local university health system based eye clinic as recommended by a pediatric ophthalmologist when needed. Demographic and school data, ocular diagnoses, and recommended treatment were assessed.
Results :
Of 1399 students screened, 387 (21%) did not pass visual acuity screening. Of these, 128 (33%) obtained parental consent for an in school dilated eye exam and 107 (28%) completed the exam. The mean age was 7 ± 2 years and 59 (55%) were female. Examined children were classified as Black or African American (36%), White or Caucasian (24%) and Hispanic/Latino (17%). Refractive error (91%) was the most common diagnosis and including hyperopia (32%), myopia (22%), and astigmatism (48%). Of those with refractive errors, 12 (12%) had hyperopia ≥ +5.00, myopia ≥ -5.00, and/or astigmatism ≥ +3.00. Glasses were prescribed to 68 children (64%). Children from the urban schools were more likely to be prescribed glasses (p<0.05) and more likely to be myopic (p<0.01) than those from suburban schools. Amblyopia (23%), anisometropia (3.7%) exotropia (2.8%), optic disc cupping (2.8%), and convergence insufficiency (1%) were also diagnosed. A 3-month follow up was recommended for 27% of children and only 24% of them attended this visit.
Conclusions :
School-based vision screening programs in high poverty urban communities can address the growing burden of pediatric eye disease, with ocular problems in addition to refractive error diagnosed. However, poor follow-up rates post-diagnosis remain a challenge.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.