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Ocular and visual status among children in special schools in Wales: the burden of unrecognised visual impairment
J Margaret Woodhouse1, Nathan Davies2, Aideen McAvinchey1
1School of Optometry & Vision Sciences, Cardiff University, Cardiff, UK.
Insights
Vision screening for children with special needs in Wales is inconsistent, with many pupils lacking eye exams and presenting with vision impairments. A dedicated school-based optometric service is urgently needed for this population.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Public Health
Background:
- Children with special needs have a high prevalence of visual defects.
- Existing vision screening guidelines are not consistently followed.
- Concerns exist regarding neglected vision care for this vulnerable group.
Purpose of the Study:
- To evaluate the current status of vision screening and eye care in special schools in Wales.
- To identify gaps in current vision care services for children with special needs.
Main Methods:
- Phase 1: Questionnaire survey of 44 special schools in Wales regarding vision screening practices.
- Phase 2: Comprehensive eye examinations for 173 pupils (aged 2-21) in five schools lacking screening services.
- Phase 3: Feedback collection from schools and parents on the perceived value of eye examinations.
Main Results:
- Vision screening was found to be patchy and inconsistent across responding schools (39 schools).
- A significant proportion of pupils (42%) had no prior eye examination.
- 17% of pupils had low vision, 50% required spectacles, and 51% had ocular abnormalities requiring attention.
Conclusions:
- There is a critical need for a structured, school-based optometric service.
- Such a service would address the significant unmet vision care needs of children with special needs.
- School-based eye care is perceived as valuable and potentially more effective for this population.
Background/Aims:
The high prevalence of visual defects among children with special needs is well reported and guidelines for vision screening are in place. However, recent research has suggested that vision care for such children is neglected. This study set out to evaluate the current status of vision screening and eye care in special schools in Wales.
Methods:
In phase 1, all 44 special schools in Wales received a questionnaire on current vision screening practices. In phase 2, full eye examinations were conducted with 173 pupils of five schools with no screening service; the pupils were aged 2-21 years. In phase 3, feedback about the service was obtained from all schools and from 15 parents whose children took part.
Results:
In phase 1, vision screening was patchy and inconsistent among the 39 schools responding. In phase 2, there is a high proportion of pupils (42%) reporting no previous eye examination. Overall, 17% of the pupils in the five schools presented with low vision (WHO definition, poorer than 0.3 LogMAR), 50% needed a first-time or updated spectacle prescription and 51% had some ocular abnormality that was either sight-limiting or warranted action to prevent risk to sight. In phase 3, school staff and parents reported that school-based eye examinations were valuable and, for those children with previous experience, likely to be more successful than clinic-based or practice-based examinations for this particular population.
Conclusions:
There is an urgent need for a school-based optometric service for this vulnerable group of children and young people.
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