Vision Screenings Frequently Refer Children From Low-Resource Neighborhoods For Care

KNOXVILLE, TENNESSEE – FEBRUARY 01: A woman looks at eye glasses at a Remote Area Medical Clinic (RAM) on February 01, 2019 in Knoxville, Tennessee. Friday is the first day of treatment for the three day clinic in what will be the health organization’s 1000th clinic. More than a thousand people are expected seeking free dental, medical and vision care at the event. RAM provides free medical care through mobile clinics in underserved, isolated, or impoverished communities around the country and world. As health-care continues to be a contentious issue in America, an estimated 29 million Americans, about one in 10, lack coverage. (Photo by Spencer Platt/Getty Images)
Patients identify a lack of insurance coverage, concerns regarding COVID-19, and scheduling conflicts as barriers to accessing care.

A vision screening program identified a third of students screened as needing referral to an eye care professional, with higher referral rates for children in materially deprived neighborhoods, according to research published in the Canadian Journal of Ophthalmology. 

Researchers conducted a study of 1127 children (mean age 5.11 years) from 41 schools to assess vision screening results, identify demographic factors associated with those results, and identify potential barriers to care. The team obtained follow-up data through a phone call placed between 1 and 1.5 years following the screening. During the conversation, investigators determined whether the children had a visit with an optometrist, whether glasses were prescribed, and patient-reported barriers to care. 

A group of 92 students who were referred to eye care providers and a control group consisting of 66 students who passed the screening agreed to participate in the study. Among these participants, 69.6% (n=64) of the referral group sought optometric care, and 34.4% (n=22) were prescribed glasses. 

Researchers noted a significant association between referral status and living in materially and socially deprived areas (P =.001 and P =.006, respectively). Those considered to be materially deprived were more likely to be prescribed glasses (P =.019), according to the report. 

Overall, participants reported a lack of insurance coverage, COVID-19-related concerns, and scheduling conflicts as the most common barriers to accessing eye care. 

“Many causes of visual impairment in children can be diagnosed and treated with full optometry or ophthalmology examination,” according to the investigators. “Despite this, children living in less resource-advantaged communities may have difficulty accessing eye care services because of factors such as socioeconomic status.”

Study limitations include reliance on self-reporting, a high loss to follow-up, and limitations on vision screenings resulting from the pandemic. 


Wang P, Bianchet S, Carter M, Hopman W, Law C. Utilization and barriers to eye care services following school-wide implementation of pediatric vision screening. Can J Ophthalmol. Published online May 4, 2022. doi:10.1016/j.jcjo.2022.04.009