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Updated: Oct 14, 2025
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Subjective Refraction Test Using a Smartphone for Vision Screening
Published on: October 18, 2024
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Visual acuity and refractive findings in children prescribed glasses from a school-based vision program
Xinxing Guo1, David S Friedman2, Michael X Repka3
1Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Dana Center for Preventive Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Summary
School-based vision programs effectively correct significant vision problems in children. Most students prescribed glasses experienced improved visual acuity, especially those with clinically significant refractive errors.
Area of Science:
- Ophthalmology
- Public Health
- Pediatrics
Background:
- School-based vision programs (SBVP) are crucial for identifying and addressing visual impairments in children.
- Early detection and correction of refractive errors can prevent long-term vision deficits.
Purpose of the Study:
- To evaluate visual acuity improvement and refractive profiles in children receiving glasses through a school-based vision program.
- To analyze factors associated with visual acuity gains in pediatric populations.
Main Methods:
- Cross-sectional analysis of pre-kindergarten to 8th-grade students failing vision screening.
- Included students prescribed glasses based on noncycloplegic manifest refraction.
- Defined clinically significant refractive error (CSRE) and assessed visual acuity improvement (presenting vs. best-corrected).
Main Results:
- Of 4,972 students, 65% had myopia, 24% hyperopia, 60% astigmatism, and 46% CSRE.
- 70% of students achieved at least a 2-line gain in visual acuity in their better-seeing eye.
- Students with CSRE showed significant visual acuity improvement, particularly older students and those from Black and Hispanic backgrounds.
Conclusions:
- The school-based vision program successfully corrected significant visual deficits in most participating children.
- SBVPs play a vital role in improving pediatric vision and addressing refractive errors.
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