Access to eye care and prevalence of refractive error and eye conditions at a high school–based eye clinic in southeastern Michigan

Abstract

To analyze clinical and demographic data from a twice monthly optometrist-run comprehensive eye program at a high school in a community with high rates of poverty. Students received comprehensive eye examinations. We collected demographic and ocular data on 429 initial visits from February 2015 to July 2019. Follow-up visits were excluded. The average student age was 14.2 ± 2.7 years. Of the total, 55.7% were female, 59.7% were Black, and 61.7% had Medicaid. Of the total, 70.2% had a previous eye examination, 60.8% had worn glasses previously, and 24.1% still wore glasses. Hispanic students were less likely than non-Hispanic students to have had a prior eye examination (59.1% vs 75.3% [P = 0.022]) or worn glasses (47.8% vs 63.8% [P= 0.035]). Black students had significantly worse presenting visual acuity in the better seeing eye than White students (logMAR 0.22 vs 0.13 [P = 0.0004]). Of the 256 Black students, 62.7% had improvement of two or more lines, compared with 42.9% of White students (P = 0.01). Of the students who participated, 74.0% received glasses following their examination, and 21 required referrals to ophthalmologists, of whom 13 attended the appointment. The high school-based clinic identified high rates of uncorrected refractive error, highlighting the benefit of a school-based eye clinic in a population with high rates of poverty. There were concerning racial and ethnic disparities in prior eye care.