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Ophthalmology examination during well-child visits in primary care health centres: Knowledge and difficulties
J P López1, M M Barriga2, D Lecea2
1Clínica Alemana de Santiago-Universidad del Desarrollo, Santiago, Chile.
Insights
Pediatric eye exams, including red reflex (RRE) and visual acuity (VA) tests during well-child visits (WCV), are infrequently performed in Chile due to lack of equipment and training. Improving primary care implementation and health worker education is crucial for early detection of childhood eye diseases.
Area of Science:
- Ophthalmology
- Pediatrics
- Public Health
Background:
- Red reflex examination (RRE) and visual acuity testing (VA) are mandatory during well-child visits (WCV) in Chile.
- These eye examinations aim for early detection of severe childhood eye diseases like retinoblastoma, congenital cataracts, and amblyopia.
- Knowledge and challenges faced by healthcare workers performing RRE during WCV in Chile are not well-documented.
Purpose of the Study:
- To assess the frequency of RRE and VA testing during WCV in Chilean primary healthcare centers.
- To identify barriers faced by healthcare workers in performing these essential pediatric eye examinations.
Main Methods:
- A survey was conducted in primary community health centers in Santiago, Chile.
- The survey targeted healthcare workers performing WCV.
Main Results:
- Physicians and nurses primarily conducted WCV (45.2% and 35.8%).
- Only 34% performed RRE and 42.3% performed VA testing.
- Key barriers included lack of direct ophthalmoscopes (55.2%) and VA charts (43.9%), alongside insufficient knowledge or skills (29.3% and 22%).
Conclusions:
- Pediatric eye examinations during WCV are infrequently performed in the studied Chilean primary care settings.
- Enhanced implementation of health centers and improved training for healthcare workers are necessary.
- These improvements are vital to enhance access and quality of pediatric eye care in primary healthcare.
Introduction:
The red reflex examination (RRE) and visual acuity testing (VA) is a mandatory part of the examination during the well-child visits (WCV) in primary health care centres of the public system of health in Chile. The eye examination is aimed at the early detection of severe eye diseases in children, such as retinoblastoma, congenital cataracts, and amblyopia. The knowledge and difficulties experienced by health workers in primary care health centres for evaluating the red reflex during WCV in Chile is unknown.
Material And Methods:
A survey was performed in primary community health centres of XXX Santiago de Chile.
Results:
The WCV were mainly performed by physicians (45.2%) and nurses (35.8%). Only 34% of health workers performed the red reflex test, and 42.3% checked VA during the WCV. The main reasons for not doing it include the lack of direct ophthalmoscopes and VA charts (55.2% and 43.9%, respectively) at their centres, and not having the knowledge or skills (29.3% and 22%, respectively) to properly perform these clinical tests.
Conclusion:
In this series, the eye examination of children attending WCV was unfrequently performed. A better implementation of the health centres and training of the health workers are needed in order to improve the access and quality of the paediatric eye examination in primary health care institutions in Chile.
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