Tag: Vision

The impact of vision on mental well-being among rural Chinese students

By Winnie Tam, Centre for University and School Partnership, The Chinese University of Hong Kong

Research findings show that visual impairment is linked to mental health issues like depression and anxiety among children, especially when refractive errors go uncorrected. A recent study published in Scientific Reports by Pang and colleagues explored the relationship between visual impairment, academic performance, and mental health among junior high school students in rural China.

The study involved a random sample of 19,425 seventh and eighth grade students from 124 schools in rural China. Researchers collected data on students’ visual acuity, eyeglasses use, academic performance (measured by a standardized math test), and mental health (assessed using the SDQ) in late 2019.

Key findings showed that 37% of the students had visual impairment, 57% of whom did not wear glasses. About 9% of all the students were at high risk for mental health problems based on SDQ scores. Students with visual impairment who did not wear glasses were more likely to experience mental health issues than those who did, and those who wore glasses had fewer mental health concerns than students with normal vision. In addition, wearing eyeglasses boosted students’ aspirations for higher education, regardless of academic performance.

The study highlights the importance of providing eyeglasses to visually-impaired students to support their mental well-being. It suggests that interventions and policies should focus on supplying eyeglasses to enhance students’ overall well-being in low-income rural settings. More on vision and school-based vision remediation may be found in earlier issues of BEIB.

Considerations when building a school-based vision program

By Chenchen Shi, Department of Theatre Pedagogy, The Central Academy of Drama, China

Pediatric vision care continues to be an unmet need in the United States, leading to disparities in access to these crucial services. Serving as an evidence-based intervention to advance health equity, school-based vision programs (SBVPs) aim to offer vision care services directly within the school setting. By forging partnerships between schools and eye care providers, SBVPs have demonstrated their ability to make a substantial impact on children’s lives, including improving academic performance and facilitating the use of eyeglasses, particularly among urban minority populations.

Despite the proven effectiveness of SBVPs, there is currently a lack of resources and comprehensive guides to assist school nurses, administrators, eye care providers, and other stakeholders in establishing and operating SBVPs. Megan Collins and her team published an article in the Journal of School Nursing, which provided practical considerations relevant to the building or strengthening of existing SBVPs.

During the program planning phase, it is essential to prioritize needs analysis, strategic partnerships, and securing adequate funding. During program implementation, components such as personnel, consent for vision exams, vision screening, eye exams, dispensing, monitoring, and replacing eyeglasses, and how to charge for exams should be fully considered. For sustainability, stakeholders need to consider data management, tracking and quality assurance. In conclusion, this article points out that SBVPs require a strong partnership between school health staff, teachers, and vision care providers in each phase. Due to school nurses’ strong ties to school health care services and the school community, they are especially positioned to build SBVPs.

Research of the feasibility and sustainability of school-based vision programs (SBVP)

By Jiebing Yang, Johns Hopkins University

Because of the lack of health care for children in the area of eye care, school-based vision programs (SBVP) have been implemented in 20 states across the US. These programs involve bringing mobile clinics into schools and providing comprehensive eye exams to detect the uncorrected refractive error needs of students who have not passed vision screening, and at the end of the exam, parents receive a letter of feedback on the student’s results. The purpose of this article is to summarize the clinical outcomes of an SBVP program in the Baltimore City Public Schools and the implications, and challenges faced. First, the screening results found that SBVP worked for children who failed screening questions in the first year of the Vision for Baltimore (V4B) program. By collecting refractive error profiles, it was found that those students who did not wear glasses had a more severe refractive error, and those who wore glasses and received prescription guidelines had improved vision. In addition, the program demonstrated impact on student achievement. Two tests, i-Ready and Partnership for Assessment of Readiness for College and Careers (PARCC), were used to measure the impact on students’ academics. The results showed that those students who wore their glasses according to the prescription guidelines performed better. While both parents and teachers found the program to be beneficial, a few problems were discussed, such as the lag in picking up glasses, missed teaching times for screenings and eye exams, and the uncertainty of test results when parents were not present. Authors discuss the role of teachers in supporting student use of regular eyewear, and the development and refinement of eye exam programs.

The effects of a school-based vision program on academic achievement

By Nathan Storey, Johns Hopkins University

Sometimes the best method to support student learning falls outside of the classroom, or beyond a teacher’s actions. A recent study by Neitzel and colleagues highlighted the effect of the Vision for Baltimore (V4B) program on student academic achievement from 2016-2019.

V4B is a school-based vision program in which students in grades preK-8 were provided with free vision screening, with eye examinations and eyeglasses (as needed) for those who failed the screenings. These activities were facilitated by a Vision to Learn mobile eye clinic, eye examinations conducted by licensed optometrists, and eyeglasses provided by Warby Parker, with free replacements available to students who lost or broke their original pair.

Neitzel and colleagues used a cluster randomized clinical trial approach including 127 schools enrolled and randomized into the study. Schools were randomized into 1 of 3 study cohorts using block randomization, with each cohort receiving the V4B intervention during different program years.

In the study of 2,304 students in grades 3-8, the researchers found an overall 1-year positive impact (ES = +0.09) in literacy (using the i-Ready reading test), as well as especially positive impacts for students in special education (ES = +0.25), and students who performed in the lowest quartile at baseline (ES = +0.28). The overall effect size of +0.09 is larger than that for most other common interventions, except for tutoring, which is typically the most effective educational intervention. Meanwhile, the effects for students in special education and those who initially performed the lowest are actually comparable to tutoring interventions.

While the study did not show a sustained impact at two years, the project does illustrate the academic benefits of providing eyeglasses to students who would otherwise struggle to access optometry care and highlights the need to understand what types of school supports are needed to maintain those impacts after the first year.