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Refractive Error Findings in Students Who Failed School-based Vision Screening
Xinxing Guo1,2, Angeline M Nguyen3, Hursuong Vongsachang1,2
1Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Ophthalmic Epidemiology
|July 23, 2021
Summary
A school vision program in Baltimore found many students with refractive errors, including myopia and astigmatism. Black and Latinx students showed higher risks for these common vision problems.
Area of Science:
- Ophthalmology
- Public Health
- Pediatric Optometry
Background:
- School-based vision screenings are crucial for early detection of eye conditions in children.
- Refractive errors, including myopia, hyperopia, astigmatism, and anisometropia, can significantly impact a child's academic performance and quality of life.
- Identifying prevalence and risk factors in diverse urban populations is essential for targeted interventions.
Purpose of the Study:
- To determine the prevalence and types of refractive errors among Baltimore City schoolchildren who failed initial vision screenings.
- To identify demographic and academic factors associated with clinically significant refractive error in this student population.
Main Methods:
- A cross-sectional analysis of 6,627 students (pre-kindergarten to 8th grade) who failed school vision screenings between 2016-2019.
- Eye examinations included non-cycloplegic autorefraction and visual acuity (VA) measurements.
- Refractive error defined by specific diopter (D) thresholds for myopia, hyperopia, astigmatism, and anisometropia; generalized estimating equation models used for risk factor analysis.
Main Results:
- 89.8% of students had some refractive error, and 35.5% had clinically significant refractive error.
- Mild myopia (45%) and low astigmatism (47%) were most common.
- Myopia prevalence increased with grade level (P<0.001), and myopia/astigmatism were more prevalent in Black and Latinx students. Higher grades and Latinx ethnicity were risk factors for clinically significant refractive error.
Conclusions:
- A significant proportion of students failing school vision screenings have refractive errors, highlighting the need for comprehensive eye care in urban, high-poverty areas.
- Black and Latinx students face a higher risk for myopia and astigmatism, necessitating culturally sensitive and accessible vision health programs.
- Early detection and intervention through school-based programs are vital for addressing vision impairments in schoolchildren.
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