School-Based Clinic Improves Visual Outcomes in Economically Disadvantaged Areas

Eye examination
Child in doctor’s office.
Researchers assess demographic characteristics of students presenting to a school-based vision clinic and measure changes in visual acuity outcomes following correction.

School-based vision clinics can identify and treat students from economically disadvantaged areas with uncorrected refractive error, according to research published in the Journal for the American Association for Pediatric Ophthalmology and Strabismus. 

Researchers obtained data from 429 patients (mean age, 14.2±2.7 years; 59.7% Black; 10.9% Hispanic; 55.7% girls; 61.7% with Medicaid insurance) presenting to a school-based vision clinic between February 2015 and July 2019. Patients reported demographic data and underwent comprehensive eye examinations. Those who needed refractive correction were supplied with eyeglasses at no cost. 

Overall, a majority of students reporting as Black or White stated they had been examined previously (76.4% and 68.5%, respectively). Students of Hispanic ethnicity, however, were less likely to have had a previous examination than their non-Hispanic peers (59.1 vs 75.3%; P =.022). 

Upon presenting to the clinic, students who were Black had worse visual acuity (VA) in their better seeing eye than children who were White (0.22±0.26 vs 0.13±0.24 logMAR; P =.0004). However, more students reporting as Black experienced a visual improvement of 2 or more lines in at least 1 eye compared with students of White ethnicity (62.7 vs 42.9%; P =.01), with several experiencing this improvement in both eyes (49.4 vs 30.0%; P =.008). Investigators also identified 18 students (4.2%) as glaucoma suspects, 37 (8.7%) with amblyopia, and 1 student with a cataract (0.2%).

“Such disparities across US settings highlight the need for improved delivery of eye care and refractive correction to racial and ethnic minority children,” according to the researchers. “Our findings suggest that school-based eye clinics, including at the high school level, may be an important tool for expanding access to eye care for these populations.”

Study limitations include a single center design and a high number of participants reporting as “other” for race. 


Killeen OJ, Zhou Y, Musch DC, et al. Access to eye care and prevalence of refractive error and eye conditions at a high school–based eye clinic in southeastern Michigan. J AAPOS. Published online July 19, 2022. doi:10.1016/j.jaapos.2022.04.009