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Stakeholders' perspectives on a digital myopia screening program in children: a qualitative analysis.

Casper van der Zee¹, Janneau L J Claessens¹, Petra T Rausch-Koster²

¹Ophthalmology Department, University Medical Center Utrecht, Utrecht, Netherlands.

Frontiers in Ophthalmology

|July 23, 2025

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Parents and children are open to online vision screening, suggesting child-friendly improvements. However, eye care professionals and policymakers express concerns about costs and reliability for widespread pediatric refractive eye testing.

Area of Science:

Ophthalmology
Public Health
Digital Health

Background:

Pediatric vision screening is crucial for early detection of refractive errors.
Current screening methods face challenges in accessibility and efficiency.
Online refractive eye tests offer a potential solution for improving pediatric vision care.

Purpose of the Study:

To identify barriers and opportunities for implementing a self-administered online refractive eye test in pediatric vision screening programs.
To gather perspectives from key stakeholders, including children, parents, eye care professionals, and policymakers.

Main Methods:

A qualitative study involving semi-structured interviews with 14 participants (children, parents, eye care professionals, policymakers).
Thematic analysis of transcribed interviews to identify key themes related to barriers and opportunities.

Keywords:

Dutch health care system children health policy online myopia screening qualitative study refractive screening stakeholder analysis telemedicine

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Incorporation of quantitative data from a concurrent clinical validation study.

Main Results:

Patients and parents responded positively to the online test concept, suggesting enhancements for user-friendliness and real-time feedback.
Eye care professionals and policymakers recognized the potential for older children (≥12 years) without high refractive errors.
Concerns were raised regarding false-positive rates, potential increases in care demand, associated costs, and the challenge of engaging populations with higher health gains.

Conclusions:

Stakeholders are receptive to online pediatric refractive screening, with suggestions for improvement from patients and parents.
Eye care professionals and policymakers highlighted concerns about cost-effectiveness and scientific validity, advocating for targeted screening of at-risk populations.
Successful implementation requires addressing screening criteria and focusing on populations that would benefit most from early detection.