Vision testing among children aged 3-5 years in the United States, 2016-2017

Questions for Lindsey Black, M.P.H., Health Statistician and Lead Author of “Vision testing among children aged 3-5 years in the United States, 2016-2017”

Q: Why did you decide to focus on vision testing for children aged 3-5?

LB: Over a quarter of all children aged 0-17 years have vision problems (1). Two common eye problems, amblyopia (lazy eye) and strabismus (crossed eyes) can be treated and prevent further vision problems if they are found early (2). The USPSTF recommends children between 3-5 years old have vision screening (3) and Healthy People 2020 target for vision screening is 44.1% of preschool aged children (1). Despite this, little is known about the current prevalence of vision screening and how this may differ by population subgroups. We focused on children 3-5 years old as they are the focus of the USPSTF recommendations.

1. Office of Disease Prevention and Health Promotion. Healthy People 2020. Washington, DC. Accessed at : https://www.healthypeople.gov/2020/topics-objectives/topic/vision/objectives
2. Office of Disease Prevention and Health Promotion. Get your child’s vision checked. Washington DC. Accessed at: https://healthfinder.gov/HealthTopics/Category/doctor-visits/screening-tests/get-your-childs-vision-checked
3. US Preventive Services Task Force. Vision Screening for Children 1 to 5 Years of Age: US Preventive Services Task Force Recommendation Statement. Pediatrics 127, 2 p340

Q: How did the data vary by age, race and health insurance?

LB: Overall, as children aged, they were more likely to have ever had their vision tested. Additionally, as children aged, they were also more likely to have had their vision tested in the past 12 months. There was also variation by race and Hispanic origin. About 65% of Non-Hispanic white children, 63% of non-Hispanic black children and 59% of Hispanic children have ever had their vision tested. Children with private health insurance (66.7%) were most likely to have ever had their vision tested compared with children with public insurance (61.2%) and children who are uninsured (43.3%).

Q: Was there a specific finding in your report that surprised you?

LB: It was surprising how much of an impact a recent well-child visit had on ever having a vision test. Children who did not receive a well-child visit in the past 12 months (44.1%) were less likely to have ever had their vision tested when compared to children that had received a well-child visit in the past 12 months (65.9%). Since vision screenings are recommended to be part of well-child visits, these visits provide valuable opportunities to detect problems and offer intervention efforts.

Q: How did you obtain this data for this report?

LB: Data are from the pooled 2016-2017 National Health Interview Survey and can be accessed via: https://www.cdc.gov/nchs/nhis.htm. Questions on vision testing are from supplement questions, which focused on expanded content related to child vision. This supplement was asked most recently in 2016-2017.

Q: What is the take home message for this report?

LB: Approximately 64% of children aged 3-5 have ever had their vision tested by a doctor or other health professional. As children age, they are more likely to have had their vision tested. Disparities exist by race, and health insurance status. Receipt of a recent well-child visit was also associated with a higher prevalence of receiving a vision test.