Guo Xinxing, Friedman David S, Repka Michael X, Collins Megan E
Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Dana Center for Preventive Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Massachussetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts.
J AAPOS. 2021 Dec;25(6):344.e1-344.e7. doi: 10.1016/j.jaapos.2021.07.013. Epub 2021 Nov 6.
We report visual acuity improvement and refractive profiles in children prescribed glasses by a school-based vision program (SBVP) in Baltimore, Maryland.
In this cross-sectional analysis, pre-kindergarten through 8th grade students who failed vision screening underwent an eye examination. Students prescribed glasses are included. Visual acuity improvement was the difference between presenting and best-corrected visual acuity based on noncycloplegic manifest refraction. Clinically significant refractive error (CSRE) was defined as ≥0.75 D myopia, ≥2.00 D hyperopia without strabismus, ≥1.00 D hyperopia with esodeviation, or ≥1.50 D astigmatism AND presenting visual acuity ≤20/40 or ≥2-line interocular difference with the better-seeing eye ≤20/30. Characteristics associated with greater visual acuity improvement were explored.
Of the 4,972 students, mean age was 9.4 ± 2.7 years; 77% were black, and 18% were Hispanic. Myopia, hyperopia, astigmatism, and CSRE were found in 65%, 24%, 60%, and 46% students, respectively. In the better-seeing eyes, 70% gained ≥2 lines. Of students with CSRE, improvement of at least 5 lines in the worse-seeing eye increased from 30.9% in pre-kindergarten and kindergarten to 77.3% in 7th and 8th grade (P < 0.001). Students with CSRE had a higher rate of gaining at least 2 lines' improvement in their worse-seeing eyes compared with those without (98.7% vs 80.6%). Older students as well as black and Hispanic students were more likely to have improvement of at least 2 lines.
Most students prescribed glasses from our SBVP had clinically significant visual deficits corrected.
我们报告了马里兰州巴尔的摩市一项基于学校的视力项目（SBVP）为儿童开具眼镜处方后的视力改善情况和屈光状态。
在这项横断面分析中，视力筛查未通过的学前班至8年级学生接受了眼科检查。纳入了开具眼镜处方的学生。视力改善是指基于非睫状肌麻痹下的显验光得出的就诊时视力与最佳矫正视力之间的差异。临床显著屈光不正（CSRE）定义为：近视≥0.75 D、无斜视的远视≥2.00 D、有内斜视的远视≥1.00 D或散光≥1.50 D，且就诊时视力≤20/40或两眼视力相差≥2行且较好眼视力≤20/30。探讨了与视力改善程度更大相关的特征。
在4972名学生中，平均年龄为9.4±2.7岁；77%为黑人，18%为西班牙裔。近视、远视、散光和CSRE分别在65%、24%、60%和46%的学生中被发现。在视力较好的眼睛中，70%的学生视力提高了≥2行。在患有CSRE的学生中，视力较差的眼睛至少提高5行的比例从学前班和幼儿园的30.9%增加到7年级和8年级的77.3%（P<0.001）。与没有CSRE的学生相比，患有CSRE的学生视力较差的眼睛至少提高2行的比例更高（98.7%对80.6%）。年龄较大的学生以及黑人和西班牙裔学生更有可能至少提高2行。
我们的SBVP为大多数开具眼镜处方的学生纠正了临床上显著的视力缺陷。
