Vision screening in children is a critical tool that aids in early detection of vision problems. Early detection is important because it has been shown to reduce the risk of vision loss at age 7 by 50%. Furthermore, children with undetected vision problems have lower academic performance than children with good vision. The American Academy of Pediatrics and American Academy of Ophthalmology recommend that starting at age one, children should have visual acuity testing using age appropriate “optotypes” such as pictures, shapes or letters. Children younger than 1 year old should have their vision examined through methods such as external inspection of the eyes and examination of the pupils.
In this report, we examine child and adolescent vision health in Chicago. Researchers at Ann & Robert H. Lurie Children’s Hospital of Chicago teamed up with the Chicago Department of Public Health (CDPH) on the 2018–19 Healthy Chicago Survey, Jr. to ask parents from all 77 community areas in Chicago whether their child had ever had their vision tested.
To understand more about vision health for Chicago children, we asked parents the following question about one randomly selected child in the household: “Has this child ever had his or her vision tested with pictures, shapes or letters?” If a parent responded yes, then we asked: “At what kind of place or places did this child have his or her vision tested?” Among Chicago youth 1–17 years old, 76% had their vision tested at some point and 24% had not (Figure 1). This is similar to national rates of vision testing (78%), although the national comparison was measured among younger children (0–5 years old) who had their vision checked.
The most common places for having a child’s vision tested were: eye doctor or eye specialist (62%), school vision testing (27%), pediatrician or other general doctor’s office (16%) and clinic or health center (8%) (Figure 2). If a child had their vision tested at more than one type of place, parents were able to select more than one response. The likelihood of getting a vision exam at school was similar for kids who attended public and non-public schools (30% and 26%, respectively).
Younger kids (1–5 years old) were less likely to have had their vision tested (44%) than kids 6–11 years old (89%) and kids 12–18 years old (94%) (Figure 2). Data from the 2016–17 National Health Interview Survey indicated that even among younger children (3–5 years old), the proportion of kids who had their vision tested by a doctor or other healthcare professional increased with age. In our survey, there were no differences in child vision testing rates by household income, child gender, parent education level, child health status or by parent’s insurance type (none, private, public). When we examined vision testing by child race and ethnicity, there was a difference in vision testing rates that approached statistical significance. Non-Latinx Black children were most likely to have had a vision screening (82%), followed by non-Latinx White children (78%), and Latinx children (73%).
In Illinois, schools are required to provide annual vision screening for all preschool children (3 years old and older) in any public or private educational program or licensed care facility, and for school age children in kindergarten, second and eighth grades. Chicago Public Schools require a vision examination upon enrollment for all children entering kindergarten and all children entering the State of Illinois for the first time at any grade level.
Vision screening for kids is important because early detection of vision problems can help prevent potential vision loss. Good vision is important for children’s physical development, overall well-being and academic success. For instance, a focus group of teachers, parents and students described how uncorrected vision deficits were connected to lower student focus, perseverance and class participation, and these reductions negatively affected academic functioning and stress. Additionally, other research shows that youth with visual deficits have lower self esteem and higher anxiety than youth without visual deficits. Visual screening can help by detecting visual problems early, preventing negative outcomes for children.