Preschool vision screening in primary care pediatric practice.

Area of Science:

• Pediatric ophthalmology
• Public health

Background:

• Knowledge regarding the effectiveness of vision screening in primary care pediatrics remains incomplete.
• Pediatric-based preschool vision screening is crucial for early detection of visual impairments.

Purpose of the Study:

• To determine the efficacy of pediatric-based preschool vision screening.
• To assess the effectiveness of vision screening in primary care settings for children aged 3-5 years.

Main Methods:

• Nine primary care pediatric practices trained staff in vision screening for children aged 3-5 years.
• Calculated testability, failure, referral, and examination completion rates, along with positive predictive values (PPVs).
• Assessed screening ease and accuracy through practice surveys.

Main Results:

• Screening identified 3.2% failure and 11.9% untestability rates; untestability was highest in 3-year-olds (27.1%).
• Positive predictive values (PPVs) for vision loss were 30.0% (3-year-olds), 77.8% (4-year-olds), and 87.5% (5-year-olds).
• Only 38.7% of children who failed screening completed ophthalmologic examinations; screening younger children was rated less easy and accurate.

Conclusions:

• Visual acuity screening demonstrated good PPV for 4- and 5-year-olds but was less effective for 3-year-olds.
• Low rates of referral and ophthalmologic examination completion were observed, especially in low-income populations.
• Improvements in screening protocols and follow-up are needed for optimal preschool vision health outcomes.