Vision Screening Prevalence and Disparities Among U.S. School-Aged Children Prior to and During the COVID-19 Pandemic.

Purpose: To examine trends and disparities in vision screening among U.S. school-aged children prior to and during the COVID-19 pandemic.

Methods: This study used nationally representative data on children aged 6-17 years residing in U.S. households from the 2016, 2017, and 2021-2023 survey years of the National Survey of Children's Health.  A child was defined as having had their vision screened if their caregiver reported that in the past 2 years the child had their vision tested (2016 and 2017) or that they visited an eye doctor or received vision screening from a provider other than an eye doctor (2021-2023).  Descriptive statistics and linear regression models were used to examine trends in the prevalence of vision screening and to assess whether the association between vision screening and sociodemographic and contextual variables changed over time.

Results: The weighted prevalence of vision screening in the past 2 years for U.S. school-aged children was 84.6% in 2016, 84.9% in 2017, 77.8% in 2021, 79.7% in 2022 and 79.6% in 2023. In regression models, lower household income, lower parental education, lack of health insurance, a primary household language other than English, not having a usual source of health care, and living in a state without vision screening requirements were associated with a significantly lower likelihood of vision screening. Screening disparities increased over time for children whose primary household language was not English or who were uninsured.

Conclusion: Public health interventions should be considered to reduce widening disparities in vision screening among U.S. school-age children.