Missed Vision Screenings for School-Age Children During The COVID-19 Pandemic: A Survey Based Study of NASN Representatives

Abstract

During the 2020–21 academic year, COVID-19-related educational disruptions impacted school-based vision screenings. However, limited information regarding changes in vision screening and the number of students impacted has been reported. Delayed screenings can negatively impact students’ referral to eye care providers, which may affect a child's ability to see clearly and academic success. This study aims to describe changes in school-based vision screening practices through a survey of National Association of School Nurses state representatives (n = 49). Among states with vision screenings mandates, participants reported that 23.7% (9/38) states waived screenings, 31.6% (12/38) continued screenings, and 36.8% (14/38) modified requirements, such as grades screened or assessments included (e.g., color vision and stereoacuity screenings). These results suggest that millions of students across the United States missed vision screenings during the 2020–21 academic year. Efforts by education and school health stakeholders should be directed towards addressing the pandemic-related disruption in vision screening.

Maryland School Health partners' Perspectives on the Impact of COVID‐19 on School Health Services for Grades K‐12

“…Now we've been able to actually do telehealth here through our family planning and STI clinics. And so again, just changing your health record system for a public health entity was a challenge Theme 3: COVID-19 affected school health staff 3.1 Staffing shortages worsened during COVID- 19 We cannot get fully staffed. I mean, we were never fully staffed prior to this.…”

Pediatric and School-Age Vision Screening in the United States: Rationale, Components, and Future Directions

“…These closures negatively impacted the delivery of various school-based health services, including school-based vision screenings. During the 2020–2021 academic year, over half of the states with vision screening mandates for school-age children either waived or modified their existing vision screening requirements, such as the grades screened or assessments included, while only approximately 30% of states continued screening without modification [ 38 , 39 ]. It is estimated that over 3 million students across the United States missed vision screenings during the 2020–2021 academic year as a result of the pandemic [ 39 ].…”

“…During the 2020–2021 academic year, over half of the states with vision screening mandates for school-age children either waived or modified their existing vision screening requirements, such as the grades screened or assessments included, while only approximately 30% of states continued screening without modification [ 38 , 39 ]. It is estimated that over 3 million students across the United States missed vision screenings during the 2020–2021 academic year as a result of the pandemic [ 39 ]. In addition, according to the NSCH data, there was an 85.7% relative increase in the number of children who did not receive vision care in 2020, as reported by their caregivers at the onset of the pandemic [ 29 ].…”

Bridging the Gap in Adolescent Vision Care Through Schools

“…Collectively, these findings, coupled with the disruption of state-mandated vision screenings during the COVID-19 pandemic, should serve as a call to action for both pediatric eye care and pediatric primary care clinicians about the need to ensure adequate vision testing across the school-age population. 8 There are some limitations of the NSCH data, as acknowledged by the study authors. 1 While intended as a nationally representative snapshot of the current state of pediatric health, NSCH relies on caregiver reports and, as such, can be susceptible to recall bias.…”

“…Using NSCH data over a 5-year period from 2016 to 2020, the study showed a decrease in reported vision testing from 69.6% to 60.1% among all children. Collectively, these findings, coupled with the disruption of state-mandated vision screenings during the COVID-19 pandemic, should serve as a call to action for both pediatric eye care and pediatric primary care clinicians about the need to ensure adequate vision testing across the school-age population …”