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Preschool vision screening in pediatric practice: a study from the Pediatric Research in Office Settings (PROS)
R C Wasserman1, C A Croft, S E Brotherton
1PROS Network, American Academy of Pediatrics, Elk Grove Village, IL 60009-0927.
Insights
Pediatricians screened fewer young children and Hispanic children for vision problems. Improved communication is needed to ensure parents understand screening results and follow-up care for children
Area of Science:
- Pediatric Ophthalmology
- Public Health
Background:
- Vision screening is crucial for early detection of visual impairments in children.
- Current vision screening practices in pediatric settings require evaluation.
Purpose of the Study:
- To describe the vision-screening process in a large cohort of preschool children.
- To identify barriers to vision screening and assess follow-up care.
Main Methods:
- Cross-sectional study of 8417 children aged 3-5 years across 102 pediatric practices in 23 states and Puerto Rico.
- Vision screening attempts, reasons for non-screening, and follow-up data were collected.
- Parental awareness of screening results and referral adherence were assessed.
Main Results:
- Vision screening was attempted in 66% of children; younger children and Hispanic children were less likely to be screened.
- Common reasons for not screening included "not routine" and "too young."
- Thirty-three percent of children did not receive latent strabismus screening; 50% of parents were unaware of failed screenings, though 85% of referred children attended appointments.
Conclusions:
- Pediatricians should increase vision screening rates in younger preschool children.
- Effective communication with parents regarding screening results and follow-up is essential.
- Systematic improvements in vision screening protocols are needed within pediatric practices.
Abstract:
In this cross-sectional study, the vision-screening process is described for 8417 children aged 3 to 5 seen for health supervision in a group of 102 pediatric practices in 23 states and Puerto Rico. Three hundred forty children who failed screening (63% of those who failed) were followed up 2 months after initial screening. The sample was 52% male, 86% white, 9% black, 3% Hispanic, and 1% Asian. Vision screening was attempted on 66% of children overall. Pediatricians' reasons for not screening were "not routine" (44%), "too young" (40%), and "screening done previously" (17%). Younger children were less likely to be screened than older children (39% of those aged 3), and Hispanics were less likely to be screened than other ethnic groups (P less than .001). Thirty-three percent of children received no screening for latent strabismus. Two months later, 50% of parents whose child had failed a vision test were unaware of this fact on questionnaire follow-up. Eighty-five percent of children referred to an eye specialist had made or kept an appointment. It is concluded that pediatricians need to increase vision screening among younger preschool children and communicate more effectively to parents the results of screening failure.