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Mayu Nishimura, Daphne Maurer, Agnes MF Wong; An Evaluation of a School-Based Screening Program to Detect Amblyopia and Refractive Errors in Kindergarten Children. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3823.
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Some 10% of kindergarten children have undetected refractive errors and 3-5% need treatment to prevent amblyopia. In many jurisdictions, there is no universal screening program to detect these problems. We evaluated a school-based program for kindergarten children (aged 3-6) in 28 schools throughout Ontario.
Screening involved 5 tests (Cambridge crowding cards, Preschool Randot, PlusoptiX S12 autorefractor, Spot autorefractor, Pediatric Vision Scanner), which took 10-15 minutes per child with a team of 5 screeners. Any child who did not pass all 5 screening tests was referred for an optometry exam with cycloplegia at school, with a parent or guardian present. If glasses were needed, they were dispensed at no cost. 2529 kindergarten children (aged 3-6 years) were screened. In Study 2, we further evaluated the efficacy of the in-school program by comparing the number of glasses prescribed through our vision checking program in 3 experimental schools (n = 581 kindergarten children) to the number of glasses prescribed in 3 comparable schools (n = 661 kindergarten children) where we did not offer our program (i.e. how many cases are detected by the status quo?). Data were analyzed using descriptive measures.
46% of the children passed screening and 54% were referred for optometry exams. 94% of parents of the referred children returned the consent form for the follow-up appointment, with 83% consenting to the in-school optometry exam. Most (80%) parents who opted out indicated that the child had already seen an eye doctor. As a result of the optometry exams, 7.2% of the screened children were discovered to have amblyopia risk factors (of which 5.3% were newly discovered) and 6.6% to have significant refractive errors (of which 4.6% were newly discovered). Results from Study 2 indicated that in the 3 control schools the number of children wearing glasses increased from 15 cases at the beginning of the school year to 20 cases by the end of the year (33% increase). In comparison, in the 3 experimental schools where we offered the program, the number of children wearing glasses increased from 14 cases at the beginning of the year to 56 cases by the end of the year (300% increase).
Both studies suggest that a school-based vision screening program can be effective in detecting eye problems that might otherwise be missed in children before Grade 1.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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