Refractive Error Clinical Trial
Official title:
A School-based Intervention to Diagnose and Treat Vision Problems in Elementary School Children With Reading Difficulty
The Baltimore Reading and Eye Disease Study (BREDS) is a two year study to determine the
prevalence of vision problems in an early school age population with reading difficulty.
Comprehensive vision and reading tests will be administered to 400 students at participating
schools in the Baltimore City Public School system.
A secondary goal is to examine the impact of vision treatment on reading performance.
Children with refractive error or convergence insufficiency will be provided treatment free
of charge. The investigators will evaluate the impact that the treatment has on vision
function and reading performance.
Learning to read is a fundamental skill taught in the early years of elementary school
education. Students who experience difficulty reading are at risk for long-term struggles
with academic achievement. In fact, achieving reading proficiency by the end of third grade
has been established as key predictor of life success.
While a number of factors contribute to reading problems, an undiagnosed or untreated ocular
condition may present one possible etiology. To the investigator's knowledge, there are no
large scale or prospective studies evaluating the prevalence of vision disorders in children
with reading difficulties. Previously, the Baltimore Pediatric Eye Disease Study performed
visual assessments in the Baltimore area for children 6 months through 5 years of age to
establish the prevalence of select ocular disorders in this pre-school population. Little is
known about the types of vision problems that affect a grade school population with and
without reading difficulty.
There is general consensus that undiagnosed or untreated vision problems may contribute to
reading difficulty, although the extent to which treatment will improve reading performance
is not well established. Although there are some studies demonstrating that treatment of
vision problems can improve reading performance, publications on the efficacy of school-based
interventions to identify and treat vision problems in school-age children are lacking. If
successful, a school-based intervention could have significant impact improving reading
performance, especially in high poverty neighborhoods where children have the highest risk of
poor reading aptitude and limited access to eye care services.
The primary goal of this research study is to determine the prevalence of vision problems in
an early school age population with reading difficulty. To adequately address this question,
the investigators will administer reading and vision assessments to 400 second and third
graders in participating schools within the Baltimore City Public School system. In addition,
the investigators will obtain information on how many children with vision problems have
received treatment in the past, and if not, why not. The investigators will also determine
how schools handle and refer children who are felt to be poor readers in order to assist with
planning future interventions.
This study will be conducted over a two-year period. In the first year, the investigators
conducted baseline vision and reading assessment on all participating subjects. In the second
year, the investigators will conduct follow up vision and reading assessments on all children
treated with eyeglasses or eye exercises and a subset of subjects with healthy eye exams. The
investigators plan to evaluate any barriers to interventions, and where possible assist in
overcoming such barriers, for example by replacing lost/broken eyeglasses.
A secondary goal is to examine the impact of vision treatment on reading performance.
Children with refractive error and convergence insufficiency will be provided treatment free
of charge. The investigators will evaluate the impact that the treatment has on vision
function and reading performance.
In subsequent phases of this project, the investigators also hope to learn how novel
treatments (e.g. iPads) impact reading performance.
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