Effect of a randomized interventional school-based vision program on academic performance

1. In this trial, students in grades 3 to 7 who received eyeglasses through a school-based vision program achieved better reading scores and had improved academic achievement. 

Evidence Rating Level: 1 (Excellent) 

The number of school-age children with uncorrected visual impairment is substantial, especially in high-poverty neighbourhoods. Visual impairment has been found to be associated with a negative impact on academic success. School-based vision programs (SBVP) offer students an opportunity to receive a thorough assessment and access to eyeglasses to mitigate these impacts. However, there has been no research examining the academic impact of SBVPs. Therefore, this study aimed to evaluate the impact of a SBVP in Baltimore on student academic achievement in English language arts (reading) and mathematics. There were 127 schools included in the study and they were stratified based various characteristics such as school type and special education status. Schools in each stratum were then randomized into one of three cohorts in a 1:1:1 ratio. Cohorts 1 (42 schools), 2 (42 schools), and 3 (43 schools) received interventions in first, second, and third program years, respectively. The intervention services included vision screenings, eye examinations, and eyeglasses, if needed. Program effect size (ES) was defined as the difference in score on a particular academic test between the intervention and control groups. The primary outcome was measured by comparing cohort 1 (intervention) with cohorts 2 and 3 (controls) at the end of the first program year, as well as comparing cohort 2 (intervention) and cohort 3 (control) at the end of the second program year. The study found that at year one, there was a positive impact on reading scores (ES, 0.09; P=0.02). No positive impact was observed for mathematics at one year. At two years, a positive intervention impact was reported on reading scores (ES, 0.08; P=0.23) and mathematics scores (ES, 0.08; P=0.20), however these results were not statistically significant. Overall, the study concluded that there was a positive impact of an SBPV on academic performance in reading, however, the results were not sustained for 2 years. Future studies should investigate reasons for the diminishing impact of SBPVs to further inform healthcare policies. 

Click to read the study in JAMA Ophthalmology

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