Analysis of vision screening failures in a school-based vision program (2016-19).


Journal

Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus
ISSN: 1528-3933
Titre abrégé: J AAPOS
Pays: United States
ID NLM: 9710011

Informations de publication

Date de publication:
02 2021
Historique:
received: 12 05 2020
revised: 02 09 2020
accepted: 19 09 2020
pubmed: 19 2 2021
medline: 19 8 2021
entrez: 18 2 2021
Statut: ppublish

Résumé

Vision screenings of a school-based program were conducted in state-mandated grades (pre-kindergarten [pre-K] or kindergarten [K], 1st and 8th grade), and nonmandated grades (2nd to 7th). During school years 2016-19, 51,593 pre-K to 8th grade students from 123 Baltimore City Public Schools underwent vision screenings, with 85% of the schools qualifying for Free and Reduced Price Meals. Assessments included distance visual acuity, Spot photoscreening, stereopsis, and cover testing. Screening failures were analyzed by grade using aggregate data. Failure rates for mandated and nonmandated grades were compared using a logistic regression model, and visual acuity distributions were analyzed using individual data. Over the 3-year period, 17,414 (34%) of students failed vision screening. Failure rates by grade ranged from 28% to 38%. Children in kindergarten and 3rd grade and higher were statistically more likely to fail screening than those in 1st grade. Reduced visual acuity was the most common reason for failure (91%). Failure rates were significantly higher in nonmandated grades than in state-mandated testing grades (34.7% vs 32.5% [P < 0.001]). Mean visual acuity of all students who failed vision screening was 20/50 in the worse-seeing eye and was 20/40 in the better-seeing eye. One-third of students failed vision screening. High screening failure rates across all grades suggest that screening in select grade levels, as currently mandated in Maryland schools, is inadequate for detecting vision problems in the low-income communities served by this program.

Sections du résumé

BACKGROUND
Vision screenings of a school-based program were conducted in state-mandated grades (pre-kindergarten [pre-K] or kindergarten [K], 1st and 8th grade), and nonmandated grades (2nd to 7th).
METHODS
During school years 2016-19, 51,593 pre-K to 8th grade students from 123 Baltimore City Public Schools underwent vision screenings, with 85% of the schools qualifying for Free and Reduced Price Meals. Assessments included distance visual acuity, Spot photoscreening, stereopsis, and cover testing. Screening failures were analyzed by grade using aggregate data. Failure rates for mandated and nonmandated grades were compared using a logistic regression model, and visual acuity distributions were analyzed using individual data.
RESULTS
Over the 3-year period, 17,414 (34%) of students failed vision screening. Failure rates by grade ranged from 28% to 38%. Children in kindergarten and 3rd grade and higher were statistically more likely to fail screening than those in 1st grade. Reduced visual acuity was the most common reason for failure (91%). Failure rates were significantly higher in nonmandated grades than in state-mandated testing grades (34.7% vs 32.5% [P < 0.001]). Mean visual acuity of all students who failed vision screening was 20/50 in the worse-seeing eye and was 20/40 in the better-seeing eye.
CONCLUSIONS
One-third of students failed vision screening. High screening failure rates across all grades suggest that screening in select grade levels, as currently mandated in Maryland schools, is inadequate for detecting vision problems in the low-income communities served by this program.

Identifiants

pubmed: 33601044
pii: S1091-8531(21)00025-2
doi: 10.1016/j.jaapos.2020.09.006
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

29.e1-29.e7

Informations de copyright

Copyright © 2021 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

Auteurs

Rachel R Milante (RR)

Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Xinxing Guo (X)

Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Amanda J Neitzel (AJ)

Center for Research and Reform in Education, Johns Hopkins University School of Education, Baltimore, Maryland.

Alyssa M Kretz (AM)

Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.

M Rani Mukherjee (MR)

Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.

David S Friedman (DS)

Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts.

Michael X Repka (MX)

Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Megan E Collins (ME)

Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland. Electronic address: mcolli36@jhmi.edu.

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Classifications MeSH