Baltimore vision screening project

Purpose: This study estimates the prevalence of common visual disorders (amblyopia, strabismus, refractive errors) in a group of inner-city school children. In addition, the study addresses the issue of access to care for vision-screening programs, specifically for children with recognized difficulties in obtaining routine medical care. Methods: School children from an inner-city elementary school were enrolled into a prospective vision-screening program combining the identification arm (screening) and diagnostic/treatment arm (ophthalmic examination). The screening consisted of Snellen E optotypes presented at a 10-foot test distance. Each child failing the vision screening was examined by an ophthalmologist at the school using a standard protocol. This allowed the authors to examine all children identified through the vision-screening program. Results: Six-hundred eighty children were screened during the 1993 to 1994 school year. Eleven percent (76) failed the vision screening and were examined, 68 of whom failed the ophthalmic examination. The estimated prevalence of visual morbidity was as follows: amblyopia, 3.9%; strabismus, 3.1%; and refractive errors, 8.2%. Conclusion: Amblyopia, strabismus, and refractive errors were found in relatively high frequencies for this population sample of inner-city children. These findings underscore the necessity of comprehensive vision-screening programs that integrate followup care. Children with limited access to specialized eye care must be provided with a mechanism for obtaining these services.