Landscape analysis of school-based vision programs in the United States: A survey study

Currently, there are neither guidelines for school-based vision program operations nor a registry of programs that exist in the United States. We aim to describe the characteristics of school-based vision programs across the United States through a survey.

We identified 10 organizations that operated one or more school-based vision programs during the 2022-2023 school year. We developed and distributed an online survey form to collect information on program demographics, program components, and protocols for vision screenings and eye exams, as well as procedures for obtaining consent, dispensing glasses, and funding resources. Organizations were asked to complete a survey for each school district in which they operated, which we defined as an individual program. Programs that did not complete the survey were excluded. We used descriptive statistics to describe program characteristics. We compared grade levels that received vision screening by school-based vision programs and their respective screening mandate in the state where the programs operated.

Seven organizations participated and provided data about 184 unique school-based vision programs. These programs operated in 19 states and the District of Columbia. All 184 programs provided vision screenings, eye exams, and eyeglasses. 94.6% of programs included instrument-based screening, with 46.7% using it exclusively. School-based vision programs most frequently screened elementary school grades. For eye exams, 81% of programs utilized opt-out consent; 21.7% of programs included dilation. Vision screenings were mostly conducted by program staff (164/184, 89.1%), and eye exams were performed by optometrists (183/184, 99.5%). Nine programs (5.0%) reported providing additional care beyond eyeglasses provision, while 135 (73.4%) reported having an established relationship with community eye care providers for students referred for additional evaluation and care.

Many school-based vision programs operate in the United States. These programs focus on vision screening, eye exams, and eyeglasses provision. Establishing a registry of programs would help to disseminate lessons learned and track outcomes data. Future programs will benefit from guidelines to ensure they are operating according to best practices.