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Eye care following pre-school vision screening: Data from the Growing Up in New Zealand study
Rebecca W Findlay1, Nicola S Anstice2, Joanna M Black1
1School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand.
Insights
Adherence to pre-school vision screening follow-up is low, especially for Māori and Pacific children. Vision screening referrals are linked to lower letter naming fluency, impacting future reading skills.
Area of Science:
- Public Health
- Ophthalmology
- Developmental Psychology
Background:
- Pre-school vision screening aims to detect visual impairments early.
- Adherence to follow-up care is crucial for effective intervention.
- The Growing Up in New Zealand study provides a valuable cohort for examining long-term outcomes.
Purpose of the Study:
- To assess adherence to follow-up appointments within New Zealand's pre-school vision screening program.
- To investigate the association between pre-school vision screening results and cognitive development at 54 months.
Main Methods:
- A retrospective record review of vision screening outcomes and ophthalmology records.
- Linkage of screening data with the Growing Up in New Zealand cohort study.
Main Results:
- 21.6% of referred children missed initial appointments, and 21.0% missed subsequent follow-ups.
- Significant ethnic disparities in attendance were observed for both referral and follow-up appointments (Māori and Pacific children had lower attendance rates).
- Vision screening outcomes were associated with letter naming fluency (p=0.01) but not name and numbers scores (p=0.05).
Conclusions:
- Low attendance rates, particularly among Māori and Pacific children, undermine the effectiveness of vision screening.
- Children with vision screening referrals showed poorer letter naming fluency, a predictor of reading ability.
- Equitable improvements in follow-up care are necessary to ensure all children receive timely eye care.
Aim:
This study aimed to determine adherence with follow-up from the New Zealand pre-school vision screening programme. The study also examined associations between pre-school vision screening outcomes and cognitive measures assessed at the 54-month follow-up in the Growing Up in New Zealand study cohort.
Methods:
A cross-sectional retrospective record review of pre-school vision screening outcomes and hospital ophthalmology records with linkage to Growing Up in New Zealand cohort study data.
Results:
Of 176 children referred from vision screening, 21.6% did not attend a referral appointment. Of 138 children who attended a referral appointment, 21.0% did not attend one or more follow-up appointments. Ethnic differences were observed in attendance at referral appointments (attended Māori 13%, Pacific 22.5%, European/Other 64.5%; not attended Māori 26.3%, Pacific 28.9%, European/Other 44.7%; P = 0.04) and follow-up appointments (attended Māori 11.9%, Pacific 15.6%, European/Other 72.5%; not attended Māori 17.2%, Pacific 48.3%, European/Other 34.5%; P = 0.001). Vision screening outcome was significantly associated with letter naming fluency scores (P = 0.01) but not name and numbers scores (P = 0.05).
Conclusions:
Non-attendance at referral and follow-up appointments limits the efficacy of vision screening, particularly for children of Māori and Pacific ethnicity. Children referred from vision screening achieve lower scores on letter naming fluency, a key predictor of reading ability in later childhood. Equity-based improvements are required to ensure that all children referred from vision screening receive appropriate follow-up eye care.
