Addressing Health Disparities in Pediatric Eye Care for School-Age Children: A Call to Action

Disparities in access to pediatric eye care among school-age children pose significant challenges to their health and well-being; addressing these disparities will necessitate coordination across multiple systems. Although vision screenings are mandated in most US states, differences persist in terms of who receives screenings and subsequent follow-up care. Racial, ethnic, and socioeconomic factors exacerbate the issue, with potential ramifications of unaddressed eye problems on learning performance and the risk of widening preexisting educational disparities. To address these challenges, various initiatives and strategic plans have emphasized the need to improve access, enhance diversity in the workforce, and promote health literacy. School-based vision programs (SBVPs) have shown promise in improving access to care and academic outcomes, but issues with integration into the health care system exist. This article explores opportunities to address structural barriers, establish resilient and equitable systems for delivering pediatric eye care to school-age children, and leverage the success of SBVPs to build stronger connections with community providers. Proposed strategies include developing standardized guidelines; establishing referral mechanisms; fostering communication with parents, teachers, and community providers; and promoting eye health literacy across the school community. Collectively, these measures aim to improve health outcomes, address social determinants of health, and reduce disparities in access to care.

Referral to Vision Rehabilitation Services for Uveitis Patients: Referral Criteria and Barriers

PURPOSE

Despite the benefits of vision rehabilitation services (VRS) for uveitis patients, limited literature has examined issues in VRS access within uveitis. We surveyed American Uveitis Society members regarding VRS referral practices, criteria, and barriers.

METHODS

Survey responses were collected from November 2022 to January 2023. Analysis summarized responses and compared response patterns of frequently-referring and infrequently-referring providers through Fisher's exact tests and logistic regression.

RESULTS

Most of the 33 respondents completed 1 to 5 monthly referrals using criteria of visual acuity loss, visual field loss, and difficulty performing vision-related activities. Key referral barriers included cost of services and insufficient patient-provider communication regarding vision loss. The practice of speaking to patients about vision loss during clinic visits was correlated with higher VRS referral rates (P = 0.047).

CONCLUSIONS

Greater patient-provider communication about vision loss may represent an opportunity to increase access to VRS.

Considerations in Building a School-Based Vision Program

The burden of childhood visual impairment and disparities in access to pediatric vision care remain pressing issues in the United States. School-based vision programs (SBVPs) serve as one approach to advancing health equity. Operating at the intersection of schools and healthcare, SBVPs can increase access to pediatric vision services, improve academic performance, and facilitate referrals to community vision care providers. To maximize their impact, SBVPs must tailor their services to the individual needs and resources of local school communities. School nurses, who have strong ties to school health care services and the school community, are trusted partners in building SBVPs. This article aims to facilitate SBVP development, implementation, and sustainability processes by offering guidance for school nurses and other stakeholders who aim to build a SBVP, support local programs, or learn more about how SBVPs operate.