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Primary Care Implementation of Instrument-Based Vision Screening for Young Children
Louis Vernacchio1,2,3, Emily K Trudell1, Jason Nigrosh1
11 Pediatric Physicians' Organization at Children's, Brookline, MA, USA.
Insights
Portable vision screening devices significantly increased screening completion rates in young children within pediatric practices. This improvement aids early detection of amblyopia and vision loss, especially in 3-year-olds.
Area of Science:
- Pediatric ophthalmology
- Public health
- Primary care innovation
Background:
- Early vision screening in children is crucial for detecting conditions like amblyopia.
- While precise portable screening devices exist, their real-world effectiveness in busy pediatric settings remains unclear.
- Traditional chart-based screening has limitations in completion rates for preschool-aged children.
Purpose of the Study:
- To evaluate the impact of deploying portable instrument vision screening devices on screening completion rates in primary care pediatric settings.
- To assess the effectiveness of the SPOT Vision Screener in improving vision screening uptake among children aged 3-5 years.
Main Methods:
- An interrupted time series analysis was used to evaluate screening completion data before and after device implementation.
- Vision screening devices were deployed in 19 pediatric practices.
- Data were collected on the percentage of 3- to 5-year-old children completing vision screening at baseline and post-implementation.
Main Results:
- Baseline chart-based screening completion was 65.3%.
- Following device deployment, screening completion significantly increased, reaching a stable 86.5% by 12 weeks (P = .007).
- Improvement was most pronounced in 3-year-olds (44.0% to 79.8%), with notable gains in 4- and 5-year-olds as well.
Conclusions:
- The implementation of portable vision screening devices substantially enhanced completed screening rates among preschool-aged children in primary care.
- These devices offer a practical solution to improve early detection of vision impairments in pediatric populations.
- Increased screening completion facilitates timely intervention for conditions like amblyopia, preventing long-term vision loss.
Abstract:
Vision screening for young children can detect conditions that may lead to amblyopia and vision loss if left untreated. Portable vision screening devices with high levels of precision are now available, but their effectiveness in busy primary care settings is unknown. We analyzed the effect of deploying instrument screening devices (SPOT Vision Screener, Welch-Allyn) in 19 pediatric practices. At baseline, using chart-based screening, 65.3% of 3- to 5-year-old children completed screening. A significant increase was observed starting 3 weeks after delivery of devices, and a stable level was reached 12 weeks after implementation, with 86.5% of children completing vision screening ( P = .007 by interrupted time series analysis). Improvement was greatest among 3-year-olds (44.0%-79.8%) but was also seen among 4-year-olds (70.9%-88.4%) and 5-year-olds (80.3%-90.8%). The deployment of vision screening devices in primary care practices substantially improved completed screening among preschool-aged children.
