Ocular Problems in Low-Income and Minority Children

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Journal of Pediatric Ophthalmology and Strabismus


Purpose: To report the prevalence rates of screen failures for uncorrected refractive error, abnormal or excessive levels of hyperopia, problems in binocular vision, and deficiency of near point acuity as related to age and ethnicity in children.

Methods: Vision screening tests were administered to 9,743 African-American, Hispanic, and white children aged 6 to 11 years in the Kansas City (United States) metropolitan area. Screening was performed by health professions students using HOTV charts for refractive errors, hyperopia, and near point acuity and a Random Dot E test for binocular vision. Children were screened in their elementary schools, located in primarily poor, urban neighborhoods. The main outcome measure was pass/fail outcomes from screenings, with confirmation of screen fails by licensed health care professionals.

Results: For African-American children, 14.1% failed one or more vision screening tests. The corresponding screen failure rates for Hispanic and white children were 14.2% and 11.0%, respectively. There were significant differences in screening failure rates as a function of age and ethnicity, depending on the specific test. The highest rates of screen failures occurred in the 9 to 11 year old age range.

Conclusions: Vision screening failures were frequently associated with age and ethnicity. Screening performed by health professions students can successfully identify potential visual problems at rates similar to those reported in studies using more complex, sophisticated testing performed by specially trained individuals.



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