Comprehensive vision care in urban communities: the pediatric outreach program

The Illinois College of Optometry's (ICO) Pediatric Outreach Program (POP) provides comprehensive vision care for high-risk children from birth to approximately 5 years of age in partnership with early intervention programs throughout the city of Chicago. Grant funds assisted in the ability to deliver vision services and spectacles to uninsured children. This report describes the structure and organization of the POP and presents the visual data.

Comprehensive eye examinations were performed on 4,298 children ages birth to approximately 5 years at 76 early intervention program sites. All of the children evaluated were enrolled from early intervention/Head Start programs. Visual acuity determination (by Lea method), assessment of binocular status, stereopsis evaluation, cycloplegic retinoscopy, and ocular health evaluations were performed. As necessary, eyeglasses were prescribed. Amblyogenic risk factors, strabismus, and ocular pathology were identified.

Of the 4,298 children examined, 49% were boys and 51% were girls. Two percent were younger than 12 months old, 6% were 1.1 to 2 years old, 12% were 2.1 to 3 years, 30% were 3.1 to 4 years, 35% were 4.1 to 5 years, 14% were 5.1 to 6 years, and 1% were older than 6 years. Hyperopia and emmetropia were the most common refractive classifications among the children examined. Approximately 6.5% had risk factors for isometropic amblyopia, and 2.3% had risk factors for anisometropic amblyopia. Approximately 1% of the children had strabismus. Less than 1% of the children examined were identified with ocular pathology. Spectacles were dispensed to 16.6% of the children examined.

The Pediatric Outreach Program provides early identification and treatment of abnormal visual conditions, ensuring that children have maximal visual acuity and visual function. The educational aspects of the program have also contributed to its successes. Education for parents and early intervention agency staff promote the importance of comprehensive vision examinations for children 5 years of age and younger.