BALTIMORE VISION SCREENING PROJECT

Purpose: This study estimates the prevalence of common visual disorder s (amblyopia, strabismus, refractive errors) in a group of inner-city school children. In addition, the study addresses the issue of access to care for vision-screening programs, specifically for children with recognized difficulties in obtaining routine medical care. Methods: Sc hool children from an inner-city elementary school were enrolled into a prospective vision-screening program combining the identification ar m (screening) and diagnostic/treatment arm (ophthalmic examination). T he screening consisted of Snellen E optotypes presented at a 10-foot t est distance. Each child failing the vision screening was examined by an ophthalmologist at the school using a standard protocol. This allow ed the authors to examine all children identified through the vision-s creening program. Results: Six-hundred eighty children were screened d uring the 1993 to 1994 school year. Eleven percent (76) failed the vis ion screening and were examined, 68 of whom failed the ophthalmic exam ination. The estimated prevalence of visual morbidity was as follows: amblyopia, 3.9%; strabismus, 3.1%; and refractive errors, 8.2%. Conclu sion: Amblyopia, strabismus, and refractive errors were found in relat ively high frequencies for this population sample of inner-city childr en. These findings underscore the necessity of comprehensive vision-sc reening programs that integrate followup care. Children with limited a ccess to specialized eye care must be provided with a mechanism for ob taining these services.