In 2019, 25.3% of U.S. children aged 2 to 17 years wore glasses or contact lenses. The percentage increased with age among both boys and girls, per data from the Centers for Disease Control and Prevention (CDC). Providing students with the glasses they need to see properly is vital for them to reach their academic potential, says a recent study published in JAMA Ophthalmology.
A Closer Look at the Study
Johns Hopkins University researchers studied students who received eye examinations and glasses through the Vision for Baltimore program. This program was launched in 2016 to meet the need for vision care among the city’s public school students. To date, Vision for Baltimore has tested the vision of more than 64,000 students and distributed more than 8,000 pairs of glasses. The Johns Hopkins team had already completed work to show how successful school-based vision programs can be in connecting students to care after a failed vision screening. They also measured the improvement in students’ vision when they received glasses. “The academic impact piece was the last part of the equation in trying to demonstrate the role of school-based vision programs in advancing health and educational equity for students,” explains senior author Megan E. Collins, MD, MPH, a pediatric ophthalmologist at the Wilmer Eye Institute and co-director of the Johns Hopkins Consortium for School-Based Health Solutions. Dr. Collins and her team carried out a three-year randomized clinical trial from 2016 to 2019, analyzing the performance of 2,304 students in third through seventh grade who received screenings, eye examinations, and eyeglasses from Vision for Baltimore. They looked at the students’ scores on standardized reading and math tests, measuring the impact after one year and two years. “It was especially exciting to see the impact for students in special education and performing in the lowest quartile at baseline,” Dr. Collins says. “The study demonstrated that something as deceptively simple as providing a student in need with glasses through a school-based vision program can be transformative for vision and learning.” It’s important to note that the academic improvements seen after one year were not sustained over two years. However, researchers suggest that this could be because students wear their glasses less over time, possibly due to breaking or misplacing them.
The Importance of Eye Care
The process of learning starts with the ability to see images, objects, and people clearly, says Reyna Betances, OD, an optometrist at Family Health Centers, NYU Langone. If a student doesn’t have that ability, eyeglasses can correct different refractive errors. Additionally, other learning skills depend on the visual system to process the incoming information appropriately. “This relies heavily on ‘binocular vision’ or the eyes’ ability to work together as a team,” explains Dr. Betances. This is especially true for reading skills, she adds, so it’s not surprising that the study demonstrated improvement in reading scores with the use of glasses. “There is a large need for pediatric eye care in our community and school-based vision programs can play a critical role providing students in need with glasses,” Dr. Collins says. “Our study demonstrates that the program not only helps children see more clearly but achieve more academically.” Dr. Collins hopes the findings will lead to a wider recognition of the interrelated nature of vision and learning and the role that school-based vision programs can play in advancing health and educational equity. “The input and support from key stakeholders, such as departments of health and education, is essential to the successful establishment and implementation of any school-based vision program,” she adds.
Accessing Pediatric Eye Care
The new research has implications for the millions of children who suffer from vision impairment but lack access to pediatric eye care. “School-based vision programs that provide an eye exam where the other aspects of vision are assessed, not only the refractive error, can identify vision problems that go beyond 20/20 vision,” Dr. Betances says. “This can have a huge impact on overall performance in children—even beyond the classroom. Children should be given all resources to succeed in school.” The American Optometric Association (AOA) recommends a child to have an eye exam as early as 6 months old. The AOA public health program InfantSEE provides free eye exams for infants between 6-12 months of age, making it a good place to start for a child’s first eye exam. “Even as infants, certain visual skills are already present and assessed during an eye exam using different techniques,” says Dr. Betances. “This can allow us as optometrists to detect any abnormalities in eye development. The next eye exam should happen between the ages of 3 to 5 and definitely before starting school. A significant portion of normal eye development occurs in the first 6 to 7 years of life.” For older children, Dr. Betances suggests that parents speak to their pediatricians about eye examinations. “More often than not, they have a network of providers where they can refer patients for further evaluation,” she says. “Furthermore, pediatricians often provide vision screenings during annual physical exams.” While a vision screening doesn’t replace a comprehensive eye examination, it can serve as a starting point in the detection of visual conditions. Parents can also take advantage of school-based programs such as the School Health Program offered by the Family Health Centers at NYU Langone, which provides services for children across the different boroughs of New York City through the public school system.
