School-Based Delivery of Eye Care: The Baltimore Experience
Moneesha R. Mukherjee, BA; Amanda J. Inns, BA, Med; Robert E. Slavin, PhD; David S. Friedman, MD, PhD, MPH; Michael X. Repka, MD, MBA; Leana S. Wen, MD, MSc, FAAEM; Gabriel W. Auteri, Esq, MBA; Megan E. Collins, MD, MPH
Wilmer Eye Institute, Johns Hopkins University
Introduction: Many children who fail vision screenings never receive recommended follow-up (1,2,3). School-based delivery of eye exams could increase access to care. This report summarizes the initial year experience of Vision for Baltimore, a city-wide initiative providing screenings, exams and glasses in inner-city schools.
Methods: 17,614 students in grades PK-8 were screened at 46 schools. Parental consent forms were sent home upon failed screening to allow an eye exam in a mobile clinic. To encourage consent collection, teachers were offered incentives (school supplies) beginning January 2017.
Results: 5,596 students failed vision screening, 3,029 (54.1%) provided consent and 2,920 (52.2%) received exams. 2,349 were prescribed glasses, and 146 students were referred for further care. Average consent return increased from 38% to 54% after incentives were offered.
Discussion: Most screening failures had refractive error necessitating glasses. Strengthening engagement with schools and providing incentives improved participation.
Conclusion: Vision for Baltimore is an effective school-based eye care model and can help inform implementation of similar programs. Opt-out consent mechanisms and barriers to participation should be explored further.
References: 1. Johnson C, Majzoub K, Lyons S et al. Eyes that thrive in school: A program to support vision treatment plans at school. Journal of School Health 2016;86(5):391-6.
2. Zhuo S, Marvin E, Wang BQ et al. Identifying barriers to follow-up eye care for children after failed vision screening in a primary care setting. J AAPOS 2013;17:385-90.
3. Williams S, Wajda BN, Alvi R et al. The challenges to ophthalmologic follow-up care in at-risk pediatric populations. J AAPOS 2013;17:140-143.