School-Based Vision Program Shown to Improve Short-term Academic Performance in Adolescents

School-based vision programs may help improve reading scores and short-term academic achievement in adolescent students, according to study findings published this week in JAMA Ophthalmology.

In school-aged children, the researchers note that the prevalence of uncorrected visual impairment due to refractive error is substantial, with only 5% to 50% of children who fail screening tests receiving follow-up care.

“These rates are especially alarming in high-poverty neighborhoods, where vision problems are more than double the national average and students face greater difficulties with access to care,” added the study authors.

With school-based vision programs having been demonstrated in prior research to improve access to care services such as eye examinations, particularly in impoverished areas, the researchers sought to evaluate whether the added provision of providing corrective eyeglasses would impact academic success.

They conducted a cluster randomized clinical trial of students in grades 3 to 7 enrolled in Baltimore City Public Schools from 2016 to 2019, as part of the citywide school-based vision program Vision for Baltimore.

For the study, 127 schools were randomized 1:1:1 to receive eye examinations and eyeglasses during 1 of 3 school years (2016-2017, 2017-2018, and 2018-2019). Schools placed in cohort 1 (intervention; n = 964) were compared at the end of year 1 with cohorts 2 (n = 775) and 3 (control; n = 565), and in year 2, the program expanded to cohort 2 (intervention), which was compared with cohort 3 (control) at year’s end.

The school-based vision program was assessed by the primary outcome of 1-year intervention impact, as measured by effect size, defined as the difference in score on an academic test (i-Ready or Partnership for Assessment of Readiness for College and Careers [PARCC] tests on reading and mathematics) between the intervention and control groups.

Secondary outcomes evaluated the 2-year intervention impact, in which the ES of cohort 1 (intervention) was compared with cohort 3 (control) at the end of program year 2.

Overall, 2304 students were included in the study (mean [SD] age, 9.4 [1.4] years; 54.7% were girls), of which 1789 students were Black (77.6%), 388 students were Latinx (16.8%), and 406 students were in special education (17.6%).

At the end of school year 2016-2017, a significant 1-year positive impact was observed in i-Ready reading test scores (ES, 0.09; P = .02). A similar positive impact was also found on i-Ready reading scores during 2017-2018, and in PARCC scores in 2016-2017 and 2017-2018, but these findings were not statistically significant. No statistically significant 1-year overall impact was found for mathematics.

Notably, significant positive impacts were observed among female students (ES, 0.15; P < .001), students in special education (ES, 0.25; P < .001), those who performed in the lowest quartile at baseline on i-Ready reading (ES, 0.28; P < .001), and among elementary school students on i-Ready mathematics during school year 2016-2017 (ES, 0.03; P < .001).

No sustained impact at 2 years was observed for the secondary outcome or on PARCC testing.

“The study provides evidence that eyeglasses not only help children see more clearly but achieve more academically,” concluded the study authors. “These findings have potential relevance for policymakers and stakeholders interested in school-based vision care.”

Reference

Neitzel AJ, Wolf B, Guo X, et al. Effect of a Randomized Interventional School-Based Vision Program on Academic Performance of Students in Grades 3 to 7. JAMA Ophthalmol. Published online September 9, 2021. doi:10.1001/jamaophthalmol.2021.3544