Effect of a Randomized Interventional School-Based Vision Program on Academic Performance of Students in Grades 3 to 7: A Cluster Randomized Clinical Trial

  • The objective of this study is to assess the effect of a school-based vision program on academic achievement among students in grades 3 to 7.

  • This cluster randomized clinical trial was conducted in Baltimore City Public Schools during school years from 2016 to 2019 among 2304 students in grades 3 to 7 who received eye examinations and eyeglasses.

  • Among the 2304 students included in the study, 1260 (54.7%) were girls, with a mean (SD) age of 9.4 (1.4) years. 

  • The analysis included 964 students (41 schools) in cohort 1, 775 students (41 schools) in cohort 2, and 565 students (38 schools) in cohort 3.

  •  There were 1789 Black students (77.6%), 388 Latinx students (16.8%), and 406 students in special education (17.6%). 

  • There was an overall 1-year positive impact (ES, 0.09; P = .02) as assessed by the i-Ready reading test during school year 2016-2017. 

  • Positive impact was also observed among female students (ES, 0.15; P < .001), those in special education (ES, 0.25; P < .001), and students who performed in the lowest quartile at baseline (ES, 0.28; P < .001) on i-Ready reading and among students in elementary grades on i-Ready mathematics (ES, 0.03; P < .001) during school year 2016-2017.

  • The intervention did not show a sustained impact at 2 years or on Partnership for Assessment of Readiness for College and Careers testing.

  • Students in grades 3 to 7 who received eyeglasses through a school-based vision program achieved better reading scores. 

  • Students had improved academic achievement over 1 year; however, a sustained impact was not observed after 2 years.

Publication date

September 10, 2021


JAMA Ophthalmology


Amanda J. Neitzel, PhD; Betsy Wolf, PhD; Xinxing Guo, MD, PhD; Ahmed F. Shakarchi, MBBS, MPH; Nancy A. Madden, PhD; Michael X. Repka, MD, MBA; David S. Friedman, MD, PhD, MPH; Megan E. Collins, MD, MPH
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