Vision conditions among first-graders of different racial/ethnic groups a year after vision screening by school nurses in Southern California

Abstract

Background: Refractive error, if uncorrected, may decrease children’s academic achievement. Pediatric amblyopia, if untreated, may lead to visual impairment. The aims were to determine the prevalence of vision conditions and untreated vision conditions during the first-grade, a year after mandated vision screening by nurses.

Methods: Ophthalmologists at the UCLA Mobile Eye Clinic (MEC) examined 2,286 first-graders located in Southern California. Myopia and hyperopia were defined as at least -0.75 dioptre (D) and +1.25Ds in each principal meridian, respectively. Astigmatism was at least a 1-D difference between the two meridians. Untreated hyperopia was defined as habitual visual acuity worse than 20/30 and the lack of eyeglasses for clinically meaningful refractive error, i.e. at least +3Ds in each principal meridian. Amblyopia was defined using a standard definition.

Results: In adjusted analysis, Asian/Pacific Islander children were more likely to have myopia compared to non-Hispanic White children. Forty-five out of 57 (78.9%) children with clinically meaningful hyperopia lacked eyeglasses. The rates of untreated hyperopia were higher in Latino/African American children and in children attending Title I schools (i.e. schools disproportionately affected by poverty) compared to non-Hispanic white and children attending a non-Title I school, respectively. Seventeen of the 2,286 children (0.74%) had amblyopia. Fourteen of the 17 children with amblyopia (82.4%) were not receiving treatment for the condition at the time of the eye exam.

Conclusions: Since most children with vision conditions lack eyeglasses or treatment in the first-grade, interventions are needed to assist the school nurses in providing follow-up eye care to children.