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  • School-Based Vision Program and Academic Performance

    By Jean Shaw
    Selected and Reviewed by Neil M. Bressler, MD, and Deputy Editors
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    Journal Highlights

    JAMA Ophthalmology, October 2021

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    Neitzel et al. set out to assess the effect of a school-based vision program on academic achievement among students in grades 3 to 7. They found that the program had a positive impact on reading scores over one year. However, a sustained benefit was not observed through a second year.

    This cluster randomized study was conducted in the Baltimore City Public School system. Participating schools were randomized 1:1:1 into one of three study cohorts, with cohorts 1, 2, and 3 receiving interventions in 2016-2017, 2017-2018, and 2018-2019, respectively.

    All told, 2,304 students received eye examinations and eyeglasses. Of these, 1,260 (54.5%) were girls; the mean age was 9.4 (± 1.4) years. Students were provided replacement eyeglasses as needed within one year of their initial prescription. The primary outcome was the one-year intervention impact, mea­sured by effect size (ES), defined as the difference in reading and mathematics test scores at the end of the year. The secondary outcome was the two-year intervention impact, measured by ES.

    Over the course of one year, students receiving eyeglasses achieved better reading scores (ES, .09; p = .02). A greater effect was noted in girls (ES, .15; p < .001) than in boys (ES, .01; p = .48), and students in special edu­cation classes and those at the lowest achievement quartiles at baseline also experienced improvement in reading scores (ES, .25 and .28, respectively; p < .001 for both). Mathematic test scores improved in elementary school grades (ES, .03; p < .001) but not in middle school grades (ES, –.21; p ≥ .99).

    The improved academic achieve­ments seen in the first year were not sustained at two years—although posi­tive intervention impacts were noted in both reading and mathematics, these im­pacts were not statistically significant. In discussing this, the authors noted that students who receive eyeglasses in school-based vision programs may wear their eyeglasses less over time.

    Refractive error findings and visual acuity change with eyeglasses in re­lation to academic outcomes will be reported separately.

    The original article can be found here.