Efficacy and outcomes of a summer-based pediatric vision screening program

Abstract

To investigate the prevalence of decreased visual acuity and uncorrected refractive error in school-aged children participating in summer programs. During the summers of 2014-2016, Wills Eye Hospital collaborated with summer programs in Philadelphia to provide vision screenings for underserved children. Parental consent was obtained prior to vision screening. Fail criteria included children in grades K-1 (ages 5-6) with visual acuity worse than 20/40 in either eye, children in grades 2-6 (ages 7-13) with visual acuity worse than 20/30 in either eye, or children with ≥2 lines of interocular difference. If decreased visual acuity was correctable to ≥20/30 by the onsite optometrist, two pairs of free eyeglasses were provided. Children with other ocular abnormalities were referred to pediatric ophthalmology. Of 1,627 children screened, 360 children (22.1%) did not pass vision screening, and 64 (3.9%) were referred. The prevalence of decreased distance visual was 34.1%. Younger children were more likely to have worse visual acuity than older children (OR=0.943; P=0.023; 95% CI, 0.896-0.992). Myopia (73%), astigmatism (56.8%), hyperopia (15.5%), spherical anisometropia (12.5%), and cylindrical anisometropia (11.9%) presented in the 303 children who underwent a manifest refraction. Myopia increased with age (OR=0.818; P=0.001; 95% CI, 0.724-0.922), whereas astigmatism decreased (OR=0.817; P<0.001; 95% CI, 0.728-0.913) with age. Two pairs of glasses were provided to 301 children. Partnership with summer programs and other community initiatives to provide vision screenings facilitates access to eye care ultimately aimed at improving social functioning and academic performance.