Although school-based vision programs provide pediatric care to students in need, vision screening failure is high, eyeglasses prescriptions are increasing and referral rates are dropping, especially in higher levels of education. Photo: Getty Images.

School-based vision programs, wherein partnerships are established between schools and local eyecare providers, are commonly seen in communities with lower socioeconomic status in order to address the lack of access to pediatric services. Such services may be the only vision care some kids receive.

In a study published in Ophthalmology, researchers from several prominent US eyecare facilities (Mass Eye and Ear, Wilmer Eye Institute, Yale and Emory) analyzed the population characteristics of schools with school-based vision programs. “Only through evaluating school-level outcomes of a program and factors associated with these outcomes can we better target schools most in need of vision services, allocate public health resources, expand current programs, and plan for future programs,” stated the researchers in their papers.

They gathered data from Hellen Keller International’s US Vision Program on the race and ethnicity of school populations with these services, the number of students eligible for meal assistance and the percent of students studying English as a second language.

In total, 410 schools were included in this study: 36.8% elementary, 37.8% middle, 5.4% high schools. The median proportion of students receiving free and reduced-price meals was 87.4%. Out of all students represented in this study, the majority (61%) were Hispanic. Black students represented the second largest population of students at these schools with 34.6%.

The researchers recorded the median rates of vision screening failure, eyeglasses prescriptions and eye care referrals from each school’s program to outline the discrepancies at these schools. Screening failure rate was  38.4%, Rx rate was 25.2% and 5.4% were referred to an eye doctor. High schools were associated both a higher rate of failure, more prescriptions and less referrals than elementary or middle schools.

“The rates of screening failure and eyeglasses prescription demonstrate a significant unmet need for vision care among the schools served by the program,” the authors wrote, emphasizing that and the association with the percentage of free and reduced-price meals demonstrates a “greater need at schools with student populations of low socioeconomic status background.” Among such populations, for every 10% increase in the number of students, the rates of screening failure, prescriptions and referrals increased by 2.6%, 1.8% and 0.86%, respectively.

While commending these programs for bridging the gap in pediatric eyecare services, the researchers concluded that “the associations between program outcomes and schools served highlight opportunities to further invest and develop school-based vision programs where they are most needed.”