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Identifying barriers to follow-up eye care for children after failed vision screening in a primary care setting
Zhuo Su1, Elizabeth K Marvin, Bing Q Wang
1Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut.
Insights
Parental unawareness of failed vision screenings is a major barrier to children receiving follow-up eye care. Clear communication and logistic support are crucial for improving timely access to pediatric eye exams.
Area of Science:
- Ophthalmology
- Pediatrics
- Public Health
Background:
- Vision impairment is a significant concern in childhood.
- Early detection through visual acuity screening in primary care is vital.
- Barriers to follow-up care can impede timely diagnosis and treatment.
Purpose of the Study:
- To identify barriers preventing children from obtaining follow-up eye care after failing a primary care visual acuity screening.
- To understand factors influencing adherence to recommended eye examinations.
Main Methods:
- A phone survey was conducted with parents of children (aged 3-14) who failed a visual acuity screening.
- The survey assessed family demographics, parental awareness of childhood eye conditions, and barriers to follow-up.
- Data were analyzed to determine factors associated with follow-up attendance.
Main Results:
- 20.5% of screened children failed the visual acuity test.
- Parental unawareness of screening results was the primary barrier (29.3%) to follow-up.
- Children with prior eye exams and shorter wait times for appointments had higher follow-up rates.
Conclusions:
- Parental unawareness of failed screenings is a key obstacle to pediatric eye care.
- Improving follow-up requires clear communication of results and education on eye health importance.
- Logistic support for accessing appointments can enhance follow-up rates for children.
Purpose:
To identify barriers to follow-up eye care in children who failed a visual acuity screening conducted by their primary care provider.
Methods:
Children aged 3-14 years who failed a visual acuity screening were identified. A phone survey with the parent of every child was conducted 4 months after the screening. Family demographics, parental awareness of childhood eye diseases and eye care for children, and barriers to follow-up eye care were assessed.
Results:
Of 971 children sampled, 199 (20.5%) failed a visual acuity screening. The survey was completed by the parents of 58 children (29.1%), of whom 27 (46.6%) presented for follow-up examination. The most common reason for failure to follow-up was parental unawareness of screening results (29.3%). Follow-up rates were higher in children with previous eye examinations than in those without (81% versus 17%; P = 0.005) and in children who waited <2 months for a follow-up appointment than in those who had to wait longer (100% versus 63%; P = 0.024). Child's sex, ethnicity, and health insurance status, parent's marital, education and employment status, household income, and transportation access were not associated with statistically significant different follow-up rates.
Conclusions:
Parental unawareness of a failed visual acuity screening is an important barrier to obtaining follow-up. Strategies to improve follow-up rates after a failed visual acuity screening may include communicating the results clearly and consistently, providing education about the importance of timely follow-up, and offering logistic support for accessing eye appointments to families.
