New findings from a study published in JAMA Ophthalmology characterized patterns in vision testing as a function of age among U.S. adolescents to identify sociodemographic determinants associated with vision testing.
Give me some background first.
Untreated refractive error contributes to the racial, ethnic, and socioeconomic disparities in visual function observed in adolescent children in the US.
This is worsened by the fact that a recent study reported that, while most states require vision screening from some school-aged children, there is significant variation in screening methods and criteria, where the screening occurs, and grade levels that are screened.
Now, talk about the study.
In this cross-sectional study, Harvard researchers used data from the National Survey of Children’s Health (2018-2019), a nationally representative survey that examines the physical and emotional health of children 0-17 years of age.
The primary outcome was the caregiver report of vision testing within the last 12 months.
Tell me more about the cohort.
In total, 24,752 adolescents aged 12 to <18 years were included; the median age was 14 years and 51% of the cohort was male.
Findings?
The caregivers of 18,621 adolescents reported vision testing in any setting within the previous year (74%).
Vision testing was reported to have occurred at:
- Eye clinics: 13,323 participants (51%)
- Primary care clinics: 5,230 participants (22%)
- Schools: 2,594 participants (11%)
- Health centers: 635 participants (4%)
What about vision testing and age?
Of note, the percentage of adolescents reported to have received vision testing decreased with age (-1.3% per year, 95% confidence interval [CI] -2.5%-0% per year) as a result of decreased testing in primary care and school environments.
And other socioeconomic factors?
After adjusting for age and sex, there were lower odds of vision testing reported for adolescents who:
- Were uninsured vs. insured (adjusted odds ratio [AOR] 0.89, 95% CI 0.84-0.95)
- Had caregivers with less than vs. greater than high school education (AOR 0.89, 95% CI 0.84-0.95)
- Were from a family born outside the U.S. vs. inside the U.S. (AOR 0.90, 95% CI 0.82-0.98)
Expert opinion?
In a commentary piece—written by researchers from Johns Hopkins University—also published in JAMA Ophthalmology, the authors noted: “Among socioeconomically disadvantaged adolescents, no difference in reported vision testing was observed when it occurred within the school setting.”
“Within the school setting, efforts should be made to develop age-appropriate, culturally competent educational resources in multiple languages to promote eye health literacy among students and their parents,” they added.
Take home.
Vision testing in adolescents decreased as a function of age due to fewer reported tests performed in primary care and school-based settings.
Further, in relation to children in socioeconomically advantaged families, those from disadvantaged families were less likely to report receiving vision testing in clinical settings.