Megan E. Collins

Uncorrected refractive error is the leading cause of vision impairment in children globally, and studies have demonstrated that spectacle correction addresses the large majority of childhood vision impairment. Furthermore, trial evidence illustrates the beneficial impact of spectacles on learning, with effect sizes exceeding that of other school health interventions. While it is established that good vision is important for learning and optimising childhood development and quality of life, many countries lack healthcare systems that provide vision screening or universal access to eyecare for all citizens. This review examined school vision screening across several regions/countries, focusing on conditions that should be targeted and the corresponding interventions. The range of international models, the status of global refractive service coverage and measures needed for improvement are discussed. Vision screening protocols need to effectively detect vision impairment, seamlessly connect with intervention services to deliver spectacles and signpost for future access to eyecare. Conditions which may not be treatable with spectacles alone, including amblyopia, strabismus and other ocular diseases, also warrant signposting for treatment. The vision community must unite to urge governments to invest in building service capacity; allocating the necessary resources and effectively developing public health systems to support vision screening and access to eyecare. Schools play a crucial role in enabling population-based vision screening and need to be supported with eyecare interventions and resources. This will ensure optimised approaches to correct avoidable vision loss and provide children with the educational and health outcomes they deserve.

Widespread racial and socioeconomic disparities exist in pediatric eye health access and outcomes. According to a National Academies of Sciences,

BACKGROUND: The COVID‐19 pandemic disrupted routine school operations, including school health programs. This study aims to describe the pandemic's impact on school health service delivery from the perspective of Maryland school health partners.METHODS: We conducted semi‐structured interviews with health service representatives from public schools (K‐12) between July and December 2021. Interviews were recorded, transcribed, and coded through an iterative process to develop analytic themes.RESULTS: Twenty school health partners from 15 Maryland school districts participated. Participants identified key impacts of COVID‐19 on school health: (1) COVID‐19 disrupted delivery of services such as dental, mental health, and preventative care, (2) COVID‐19 necessitated changes in service delivery platforms, (3) COVID‐19 affected school health staff through increased responsibilities and staffing shortages, and (4) COVID‐19 prompted schools to become hubs for community outreach and health education.IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Consideration of school health service disruptions and the increased demands on service providers may inform future priorities for school administrators, health departments, and policymakers.CONCLUSIONS: COVID‐19 impacted the timing and method of service delivery as well as the roles of school health staff and schools themselves in public health and education.