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Vision Testing for Adolescents in the US.

Isdin Oke^1,2, Natalie Slopen³, David G Hunter¹

¹Department of Ophthalmology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.

JAMA Ophthalmology

|October 12, 2023

Summary

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Vision testing for adolescents decreases with age, particularly in primary care and school settings. Disadvantaged youth show lower vision testing rates, highlighting a need for improved access to address disparities in untreated refractive error.

Area of Science:

Ophthalmology
Public Health
Pediatrics

Background:

Untreated refractive error contributes to significant disparities in visual function among US adolescent children.
Racial, ethnic, and socioeconomic factors are linked to these disparities in visual health outcomes.

Purpose of the Study:

To analyze age-related patterns in vision testing among US adolescents.
To identify sociodemographic factors associated with receiving vision testing in this population.

Main Methods:

Cross-sectional study utilizing data from the National Survey of Children's Health (2018-2019).
Included 24,752 US adolescent children aged 12 to <18 years.
Analyzed caregiver-reported vision testing using linear and logistic regression models.

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Main Results:

Overall, 74% of adolescents received vision testing in the past year, with rates decreasing by 1.3% per year of age.
Testing rates declined in primary care and school settings as age increased.
Adolescents who were uninsured, had caregivers with lower educational attainment, or were from immigrant families had lower odds of vision testing.

Conclusions:

Vision testing rates in adolescents decline with age, primarily due to reduced testing in primary care and school settings.
Socioeconomically disadvantaged adolescents are less likely to receive vision testing.
Expanding school-based vision testing for older, disadvantaged adolescents could help mitigate disparities in untreated refractive error.