Uncorrected refractive errors: An unnecessary disadvantage for low-income students

Background/Purpose: Refractive errors are common among school-aged children, but are readily addressed with prescription glasses. Poor vision directly interferes with learning, and limited access to vision care and the cost of glasses may be prohibitive barriers to adequate vision correction.

Methods: The Kress Vision Program is a non-profit organization that provides free prescription glasses and ocular health screenings to high-need populations throughout New York City. Kress provides pediatric services to public and charter schools at the schools’ request. Screening records were reviewed retrospectively.

Results: From January-June 2013, Kress examined 569 children at 17 schools. Examinees ranged in age from 5-18 (mean 12.2 ± 0.3 yr), 267 (46.9%) were female, and 302 (53.1%) were male. While 105 (18.%) children had initial visual acuity worse than 20/100 by Snellen chart, only 32 (5.6%) were already wearing glasses, an additional 197 (34.7%) reported that they had lost or broken their glasses, and 340 (59.8%) had never been prescribed glasses. Boys were more likely than girls to report having lost or broken their glasses (OR: 2.46, 95% CI: 1.13, 5.34, p= 0.022). In total, 408 children (71.7%) were prescribed glasses and 61 children (10.7%) were referred for more advanced evaluations. The most common reason for referral was poor visual acuity and suspected amblyopia.

Conclusions: Uncorrected refractive errors were common in the study population. Children’s vision needs are sensitive to economic pressures because they are highly likely to lose or break a sole pair of glasses, and require regular exams to update their prescriptions as they grow.