Access to eye care and prevalence of refractive error and eye conditions at a high school–based eye clinic in southeastern Michigan

Purpose To analyze clinical and demographic data from a twice monthly optometrist-run comprehensive eye program at a high school in a community with high rates of poverty. Methods Students received comprehensive eye examinations. We collected demographic and ocular data on 429 initial visits from February 2015 to July 2019. Follow-up visits were excluded. Results The average student age was 14.2 ± 2.7 years. Of the total, 55.7% were female, 59.7% were Black, and 61.7% had Medicaid. Of the total, 70.2% had a previous eye examination, 60.8% had worn glasses previously, and 24.1% still wore glasses. Hispanic students were less likely than non-Hispanic students to have had a prior eye examination (59.1% vs 75.3% [P = 0.022]) or worn glasses (47.8% vs 63.8% [P = 0.035]). Black students had significantly worse presenting visual acuity in the better seeing eye than White students (logMAR 0.22 vs 0.13 [P = 0.0004]). Of the 256 Black students, 62.7% had improvement of two or more lines, compared with 42.9% of White students (P = 0.01). Of the students who participated, 74.0% received glasses following their examination, and 21 required referrals to ophthalmologists, of whom 13 attended the appointment. Conclusions The high school–based clinic identified high rates of uncorrected refractive error, highlighting the benefit of a school-based eye clinic in a population with high rates of poverty. There were concerning racial and ethnic disparities in prior eye care.