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Children with Additional Support Needs Risk Missing Out on Effective Vision Screening: Audit and Survey Considering
Cirta Tooth1, Julius Rogowski2
1Princess Alexandra Eye Pavilion, UK.
Insights
Vision screening follow-up attendance is low, especially for children with additional support needs (ASN). Improving accessibility is crucial for timely eye care and better vision outcomes in preschoolers.
Area of Science:
- Pediatric Ophthalmology
- Public Health
- Vision Science
Background:
- Preschool vision screening identifies visual impairments before school entry.
- Early intervention supports educational, developmental, and social well-being.
- This study examines follow-up attendance and barriers in an urban hospital setting.
Purpose of the Study:
- To evaluate attendance rates for children needing follow-up after preschool vision screening.
- To identify barriers to attending hospital eye appointments.
- To assess the impact of interventions on visual acuity.
Main Methods:
- Retrospective data analysis of attendance, visual acuity, and refractive errors.
- Inclusion of additional support needs (ASN) data.
- Telephone surveys with caregivers of children with missed appointments.
Main Results:
- First-time hospital attendance rate was 61%.
- Children with ASN were 1.8x more likely to miss appointments and have incomplete tests.
- Vision improved significantly with spectacle prescription (0.07-0.16 LogMAR).
- Barriers included lack of awareness, ASN, hospital environment, scheduling, and transport.
- Parent recommendations focused on accessible information, reminders, and community-based testing.
Conclusions:
- Despite high initial screening uptake, significant follow-up non-attendance occurs.
- Children with ASN face greater challenges accessing timely eye care.
- Service accessibility improvements are vital for children with ASN to prevent vision deficits.
Objective:
Vision screening programs in children aged 4-5 years aim to address visual issues before they start school, supporting children's educational, developmental, emotional, and social well-being. This study evaluates attendance rates and barriers to attendance for children requiring follow-up in an urban hospital eye service after their initial screening visit.
Methods And Analysis:
Retrospective data on attendance, visual acuity, refractive errors, and presence of additional support needs (ASN) were collected from the National Database for preschool screening and the hospital electronic record system. Caregivers of children with missed appointments were invited for a telephone survey.
Results:
First-time hospital attendance rate was 61%. Children with ASN were 1.8× more likely to miss two hospital appointments and had more incomplete tests compared to children without ASN. In children receiving a spectacle prescription, vision improved by 0.07 LogMAR in the better eye and 0.16 LogMAR in the worse eye. Barriers for attendance included being unaware of the appointment, ASN, hospital environment, scheduling and transport issues. Parents recommended information with the appointment letter in an accessible language for the child and caregiver, an appointment reminder text message and options for vision tests in the community or at school.
Conclusion:
Whilst the initial uptake of vision screening is high, there is a significant proportion of children with incomplete screening tests or missed follow-up appointments. Greater attention should be placed on improving accessibility of the service for children with ASN, as they may be at greater risk of missing out on appropriate eye care.
