Association of state vision screening requirements with parent-reported vision testing in young children

Abstract

To examine the relationship between state school vision screening requirements and the likelihood that children 3-5years of age receive vision testing. We obtained nationally representative data from the 2016 National Survey of Children's Health on children ages 3-5 (n=7,567) and used available sources to compile state policies that mandate childhood vision testing. We calculated the rates of parent-reported vision testing for each state and fit logistic regression models using survey-based estimation methods with nationally representative weights. Our models controlled for factors such as age, sex, race/ethnicity, and insurance coverage. Additional analyses added comorbidities that may lead to an eye care provider referral. Parent-reported vision testing rates by state ranged from 41% to 84%. A significant association was found between the presence of state-level vision screening requirements and parent-reported vision testing, which remained after controlling for comorbidities (aOR=1.374; P=0.016). Of these comorbidities, arthritis, blindness, and very low birth weight were associated with a higher rate of vision screening (all P<0.05). The presence of a state-level school vision screening requirement is associated with increased parent-reported vision testing in children 3-5years of age. This suggests that state policy may ensure timely screening for amblyopia and other sight-threatening complications.