Baltimore Reading and Eye Disease Study: vision outcomes of school-based eye care

Objective: There are unmet needs for refractive correction in the pediatric population, especially in high-poverty communities. We reported the impact of refractive correction on vision outcomes over a 2-year follow-up in the Baltimore Reading and Eye Disease Study. Design: Prospective, school-based cohort study. Participants: Students of second and third grades who were prescribed glasses during baseline assessment. Methods: We conducted baseline eye exams in 12 Baltimore public schools during the fall of school year 2014-15 with follow-up visits in the spring of school year 2014-15 (first follow-up) and school year 2015-16 (second follow-up). Visual acuity (VA) was measured at distance and near with correction. Refractive status was determined based on the eye with the larger refractive error and categorized as myopia, hyperopia, and astigmatism. Main outcome measures: VA in better-seeing and worse-seeing eye at first and second follow-up, and acuity improvement from baseline. Results: In the 206 students (84% African American) who completed the first follow-up, both distance (from 0.14 +/- 0.20 to 0.05 +/- 0.10 logMAR) and near presenting VA (from 0.08 +/- 0.16 to 0.03 +/- 0.06 logMAR) improved from the baseline assessment; children with more severe hyperopia showed improvement in near VA by 0.05 +/- 0.16 logMAR. Children who were prescribed glasses through a school-based research study had improved vision, which was sustained into the following school year. Conclusions: Many second and third graders in Baltimore Schools needed refractive correction and benefited from provision of glasses with sustained vision improvement over the 2-year observation.