Race, Poverty Affect Follow-Up Rate After School Vision Screenings

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Researchers analyzed data from 2014 to 2019 in 271 Arkansas school districts.

This article is part of Ophthalmology Advisor’s conference coverage from the 2021 meeting of the American Academy of Ophthalmology, held in New Orleans from November 12 to 15, 2021. The team at Ophthalmology Advisor will be reporting on a variety of the research presented by the ophthalmology experts at the AAO. Check back for more from the AAO 2021 Meeting.


Race was associated with failure to follow up after vision screenings in Arkansas school districts, according to research results presented at the American Academy of Ophthalmology 2021 Annual Meeting, held November 12-15.1

Researchers at the University of Arkansas for Medical Sciences sought to identify reasons why failure to follow up in school district vision screenings occurs. They reviewed data of 1.27 million vision screenings that occurred between 2014 and 2019 in 271 Arkansas school districts that served students in preschool through eighth grade. Utilizing data from the Arkansas Department of Education and Health Services and the U.S. Census Bureau, the researchers analyzed the associations that demographic and socioeconomic factors had with patients’ failure to follow up on eye screenings.

Of an estimated 257,287 children each year who completed screenings, 9.5% failed them. Nearly all (94.5%) school districts had follow-up rates less than or equal to 60%. The mean follow-up rate across the districts was 33.5%.

Follow-up rates were lower in school districts with more students who are Black (r=-0.418 P <.001) and students in poverty (r=-0.243 P <.001). Districts with more students who are White (r=0.318 P <.001) and students enrolled in the Children’s Health Insurance Program (r=0.264, P =.022) had higher follow-up rates.

“The inadequate follow-up eye care for AR children who fail school vision screenings should be addressed, especially in schools with high rates of minority race and low-income families,” the investigators said.

Many studies have evaluated solutions to an annual challenge: encouraging students who fail vision screenings to present at ophthalmologists for comprehensive eye exams

A study published in Clinical Ophthalmology indicated that complete eye exams performed at an ophthalmology clinic in Wheaton, Illinois, had a higher follow-up rate yet reduced cost-benefit ratio compared with traditional screening programs.2

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1. Ly V, Brown CC, Cannon TC. Race, poverty and the lack of follow-up for Arkansas students who fail vision screenings: a cross-sectional study. Presented at: American Academy of Ophthalmology 2021 Annual Meeting. PA017.

2. Ekdawi NS, Kipp MA, Kipp MP. Mandated kindergarten eye examinations in a US suburban clinic: is it worth the cost? Clin Ophthalmol. Published online March 8, 2021.  doi:10.2147/OPTH.S300725