School eye exams identify refractive error, other vision problems

August 10, 2021

2 minutes to read

Source / Disclosures

Disclosures: The authors do not report any relevant financial disclosures.


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Eye exams that assess children’s various vision problems, including refractive error, were achievable in school settings, according to results published in the Canadian Ophthalmological Society newspaper.

“The Baltimore Reading and Eye Disease Study (BREDS) was conducted to determine the prevalence of refractive error and other vision problems among young school-aged children in very poor elementary schools, to identify associations between reading performance and refractive error and to study the impact of vision interventions in schools ”, Megan E. Collins, MARYLAND, ophthalmologist at Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center, and colleagues wrote. “A secondary objective was to quantify the number of children screened who would have failed eye screening in the state of Maryland and to explore the feasibility of conducting comprehensive school eye exams in the early years of the year. primary.”

In a prospective school-based cohort study, Collins and colleagues analyzed data from 321 youth in grades two and three (aged 7.9 years; 57.9% girls; 84.4% African Americans ; 4.7% Caucasians; 9% Hispanics). Participants came from 12 different Baltimore public schools during the 2014-2015 school year.

The children underwent basic eye examinations, including near and far visual acuity (VA), stereopsis, eye alignment, dilated retinal examination, and cycloplegic refraction to assess the feasibility of eye examinations in school.

Of the students surveyed, 33.6% wore glasses before and 6.9% wore glasses initially.

Examinations revealed that the mean presentation distance and near VA were 0.1 ± 0.2 logMAR (range –0.1 to 1.5) and 0.1 ± 0.2 logMAR (range 0-1.6) in the better seeing eye. Likewise, the most common ocular findings were hyperopia of +1.00 D or more (34.7%), myopia of –0.5 D or more (29.5%), astigmatism of 1.00 D or more (23.4%) and insufficient convergence (7.2%).

After the exams, 210 out of 307 students (68.4%) received a prescription for glasses and 37 students (11.5%) were referred to a pediatric ophthalmologist for further evaluation.

Overall, refractive error was the most common vision problem identified in BREDS.

“In general, the participants had good distance and good near acuity. However, about one in four students would have failed Maryland’s visual screening on the basis of reduced acuity alone, ”Collins and colleagues wrote. “We were able to successfully perform comprehensive school eye exams in over 95% of the study population, with the provision of glasses when needed, confirming the feasibility of this approach for routine refractive needs. “

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