Vision screening outcomes of 4-5 year-olds reflect the social gradient

ABSTRACT

Clinical relevance

Children in socioeconomically disadvantaged communities often do not access follow-up eye care services when referred from vision screenings; whether this is due to lack of availability is not known. This paper highlights the need for vision and eye care for vulnerable children with practicing clinical optometrists well placed to provide vision care.

Background

Vision impairments develop from a young age and may inhibit learning experiences and impact life outcomes. Vision screening to detect and refer vision abnormalities supports children in their education and prevents minor vision impairments from worsening. This research describes outcomes from a vision screening programme for 4– to 5-year-olds delivered in Queensland, Australia.

Methods

The programme involved all prep children from participating schools in Queensland. Vision screening was conducted with the Parr 4 m Visual Acuity Test and Welch Allyn Spot Vision Screener. A cross-sectional study design was adopted. Descriptive data analyses explored the frequency of vision screening and referral outcomes. Inferential analyses examined associations between vision screening and referral outcomes with socio-economic indexes for areas (SEIFA) scores  .

Results

Of 71,003 prep students screened, 4,855 (6.8%) received a referral recommendation. A higher proportion of children who received a referral recommendation was from more disadvantaged locations (?2 = 109.16, p < 0.001). Of the students referred, 3,017 were seen by an eye health professional. Further vision assessment of students by an eye health professional revealed that 43.3% of the referred children were diagnosed with a vision abnormality, 18.9% had no vision abnormality and 37.7% had an ‘undetermined’ diagnosis. A higher proportion of children confirmed with a vision abnormality were from more disadvantaged locations (?2 = 52.27, p < 0.001).

Conclusion

It is important that vision screening programmes target disadvantaged populations and support families of children who require further health assessment to access health services.

KEYWORDS:

• Child development
• pre-school children
• social gradient
• vision screening

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. Diagnoses of 9 students assessed by eye health professionals were missing.

2. Note that the percentages add up to >100% because some people had multiple diagnoses, for example a refractive error in addition to another unspecified abnormality.

Additional information

Funding

This study was funded by Children’s Health Queensland Hospital and Health Services [CHQ 187-2016].