Inadequate Follow-Up Eye Care Remains a Concern in Underserved Communities

Inadequate follow-up eye care among children who failed vision screenings persists in underserved populations and may be associated with race, academic achievement, poverty level, and insurance status, according to a study published in the Journal of the American Association for Pediatric Ophthalmology and Strabismus.

Researchers conducted a cross-sectional study to determine follow-up rates among a cohort of students who failed school vision screenings during a 7-year period in 238 school districts. The team obtained vision screening, demographic, socioeconomic, academic, and eye care provider data and estimated associations between follow-up rates and characteristics associated with the school district, which included race, poverty, insurance coverage, academic achievement, and the number of optometrists and ophthalmologists practicing within an area.

Overall, the study included 1,744,805 vision screenings between 2013 and 2020. The report revealed inadequate eye care follow-up rates — 35.4% of eligible students underwent screening each year and the failure rate ranged from 8.0% to 9.4%. Follow-up rate was between 20% and 50% in two-thirds of districts and less than 60% in 91% of districts.

Higher follow-up rates were associated with a higher concentrations of students who were White (P <.001), higher graduation rates (P =.024), higher percentages of students with government-assisted insurance (P =.035), and higher standardized test scores (P <.001). No associations were determined to exist between follow-up rates and the number of ophthalmologists, optometrists, or school nurses per school district.

“Interventions to improve follow-up eye care for students that fail school vision screenings
must consider and address the barriers that students and families face,” according to the study authors. “School-based vision programs in several cities have expanded to include additional interventions that circumvent barriers for students that need eye care.”

Study limitations include the use of free or reduced-cost lunch as an indicator of low income, nurse-reported follow-up rates, incomplete ophthalmology provider counts, and a failure to obtain grade level data.