Shortfall in Vision Testing for Chicago Children

August 26, 2020

Nearly 1 in 4 Have Never Been Screened

Although good vision is important for children’s physical development and academic success, 24 percent of Chicago’s children and adolescents ages 1-17 have not had their vision tested, according to a survey of parents released by Ann & Robert H. Lurie Children’s Hospital of Chicago and the Chicago Department of Public Health (CDPH).

Lack of testing was a more significant problem for younger children, and testing appeared to increase as children grew older. Survey results showed that 44 percent of children ages 1-5 had at least one vision test, compared to 89 percent of children ages 6-11 and 94 percent of adolescents ages 12-17. Visual testing for children involves asking children to identify shapes, letters and pictures.

“Starting at a very early age, good vision is crucial for healthy brain development and overall well-being. If some young children are not receiving vision testing, we are missing important opportunities to intervene in the early childhood years when corrective therapies can be helpful,” says Matthew M. Davis, MD, MAPP, Chair of the Department of Medicine at Lurie Children’s, President and Chief Research Officer of the Stanley Manne Children’s Research Institute, Executive Vice-President and Chief Community Health Transformation Officer at Lurie Children’s and Chair of the Department of Pediatrics at Northwestern University Feinberg School of Medicine.

Children younger than one year old are recommended to have their visual acuity tested by health care providers who examine the eyes. In Illinois, preschools are required by law to screen all children annually, starting at age three, and testing must also occur in kindergarten and in grades two and eight. Chicago Public Schools also require a vision examination for children entering Illinois’ education system for the first time at any grade level. The survey found that the most common places where children received vision tests were at the eye doctor or eye specialist (62 percent) and public or private school testing (27 percent), followed by screening conducted by their pediatrician (16 percent) or at a health center (8 percent).

“Vision testing is a priority for children’s health and children’s education. No matter where the test is conducted, parents need to make sure their child’s eyesight is examined as early as possible and continue to follow their child’s vision health as they grow,” says Dr. Davis.

Parent responses to the survey found no disparities in vision testing as determined by household income, gender, parent educational level or type of insurance. However, apparent differences emerged by race and ethnicity: Black children were most likely to have had a vision test (82 percent), followed by White children (78 percent) and Latinx children (73 percent).

Early detection of vision problems is critical because it can help prevent potential vision loss that can otherwise last a lifetime and affect a child’s self-esteem and anxiety. For example, the best outcomes for patients with amblyopia (sometimes referred to as lazy eye), the leading cause of pediatric vision loss, are achieved if a child is treated before age 7. Other research involving teachers, parents and students illustrates how uncorrected vision deficits in 13- to 17-year-olds decreased students’ focus, perseverance and class participation and increased their stress.

Survey answers are from the second wave of data collection through the Healthy Chicago Survey, Jr. (2018-19) that was developed by Dr. Davis in collaboration with the CDPH Office of Epidemiology and Research. Phone interviews were conducted with 2,982 adults, including 740 parents, from December 2018 through May 2019. Households across Chicago were randomly selected, with participants in all 77 community areas. The survey cooperation rate was 12 percent.

To share the survey results, Dr. Davis and his team at Lurie Children’s launched “Voices of Child Health in Chicago,” a research program focused on bringing the perspectives of Chicagoans to inform dialogue and action about child health in the city. On a regular basis, data briefs are issued that report on a wide range of survey result topics that affect youth health in Chicago.

Population-focused child health research at Ann & Robert H. Lurie Children’s Hospital of Chicago is conducted through the Mary Ann & J. Milburn Smith Child Health Research, Outreach, and Advocacy Center at the Stanley Manne Children’s Research Institute. The Manne Research Institute is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of new knowledge. Lurie Children’s is ranked as one of the nation’s top children’s hospitals in U.S. News & World Report. It is the pediatric training ground for Northwestern University Feinberg School of Medicine. Last year, the hospital served more than 220,000 children from 48 states and 49 countries.

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