Low-income children who fail school vision screenings receive follow-up eye exams less than 50% of the time, with Black and Hispanic students most affected

US school-based vision screening programs identify millions of children with potential vision problems annually, but fewer than half of children who fail these screenings ever receive a follow-up comprehensive eye exam -- and among Black and Hispanic students, follow-up rates are even lower, despite these groups having higher screening failure rates. Why it matters: children who fail vision screening but never receive follow-up care continue to sit in classrooms unable to see the board clearly, so their academic performance suffers measurably (studies show 0.1-0.2 standard deviation improvement in reading scores when children receive needed glasses), so teachers misidentify these children as having learning disabilities or behavioral problems, so these children are disproportionately tracked into remedial programs or disciplined for 'not paying attention,' so the educational achievement gap between low-income/minority students and their peers widens due to an entirely correctable physical condition. The structural root cause is that school vision screening mandates exist in most states but include no funding or infrastructure for follow-up care, transportation to appointments, or provision of glasses, creating a system that identifies problems but provides no pathway to solve them -- and schools with predominantly low-income students are least likely to have full-time nurses who can coordinate follow-up care.