BALTIMORE VISION SCREENING PROJECT - PHASE-2

Background: Vision screening in preschool and school age children rema ins a valuable method of identifying potentially treatable visual abno rmalities, as well as refractive errors in the school age population. A major difficulty in conducting these types of programs is the incons istent follow-up encountered frequently in children identified by the screening program, The Baltimore Vision Screening Project was designed to address the issue of access to care for a group of inner city elem entary school students by providing on-site evaluation and treatment. Methods: A standard vision-screening protocol was administered to prek indergarten and kindergarten students attending an inner city elementa ry school and access to care provided at the school, Children identifi ed by the screening were examined at the school, and appropriate treat ment was prescribed. The second phase of the study details a return to the school 1 year after the initial screening, The purpose of this wa s to reassess the level of visual morbidity in this population and to evaluate the effects of providing treatment in the previous year. Resu lts: Two hundred eighty-five children were screened during the 1994-19 95 school year. Visual morbidity statistics from the follow-up year we re similar to those of the previous screening: 5.3% diagnosed with amb lyopia, 3.2% with strabismus, and 7.4% with refractive errors. Forty o f the 68 children identified, examined, and treated in the previous ye ar still were attending the school during the follow-up investigation. Compliance with recommended treatment was 30% in this group, with onl y 20% of the students passing the vision screening the following year. Conclusions: The follow-up screening confirmed the presence of signif icant visual morbidity in this group of preschool and kindergarten stu dents. Nearly two thirds of the students had not complied with the rec ommended treatment or spectacle wear or both, despite providing immedi ate access to this care through the vision-screening program.