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From Screening to Care: Delayed Clinical Follow-up After Childhood Myopia Identification and the Design of a
Wei Pan1, Xiaofan Xu2, Peixuan Li3
1Aier Academy of Ophthalmology, Central South University, Changsha, China.
Insights
Delays in seeking clinical care for myopia are common in China. This study investigates interventions to shorten the time to the first myopia-related clinic visit after screening.
Area of Science:
- Ophthalmology
- Public Health
- Pediatric Eye Care
Background:
- Myopia screening identifies children needing eye care.
- Delays in seeking clinical care after screening are a concern.
- Pilot study investigates these delays and designs a prospective cohort study.
Purpose of the Study:
- To investigate delays in seeking clinical care after myopia screening.
- To design a prospective cohort study to test interventions for shortening these delays.
- To assess parental knowledge, attitudes, and behaviors toward myopia.
Main Methods:
- Pilot study surveyed parents at a myopia clinic.
- Prospective study involves Grades 1-3 students in four primary schools.
- Random assignment to visual acuity app, education videos, both, or control groups.
Main Results:
- In the pilot, 41.0% of parents waited >12 months for the first myopia visit.
- High parental recognition of myopia risks and prevention methods was observed.
- Prospective study aims for 2400 subjects with time to visit as primary outcome.
Conclusions:
- Preliminary findings suggest common delays in children's first myopia clinic visits in China.
- Systematic evaluation of myopia screening and health education is needed.
- Interventions may be effective in reducing delays and improving eye care access.
Background:
This study was a pilot investigation on delays in seeking clinical care after myopia screening and describes the design of a prospective cohort study to test whether additional intervention can shorten the delay in seeking eye care.
Methods:
In the pilot study, parents who brought their children to the myopia clinic were surveyed regarding their knowledge, attitudes and behaviours toward myopia. Comparisons between first-time myopia visits (FTMV) and non-first-time myopia visits (NFTMV) were made using the Chi-squared test. The prospective study will involve Grades 1-3 students from four primary schools. Each will be randomly assigned to one of four groups: (1) self-examination visual acuity app; (2) myopia-education videos; (3) both interventions or (4) control. Visual acuity, non-cycloplegic auto-refraction and questionnaires will be collected at baseline and 6-month visit.
Results:
In the pilot study, 496 valid questionnaires were included (173 FTMV; 323 NFTMV). In both groups, 74.6% recognised that myopia can lead to blindness (p = 0.99). In the FTMV and NFTMV groups, 95.4% and 97.8% believed that myopia can be prevented and controlled (p = 0.13), 92.5% and 94.1% identified short reading distance as a risk factor (p = 0.48) and 97.7% and 98.8% recognised poor indoor lighting as a risk factor (p = 0.37), respectively. Among FTMV parents, 41.0% reported waiting >12 months before seeking clinical care. In the prospective study, a total of 2400 subjects are anticipated. The primary outcome is the time to myopia-related clinical visit after screening, using survival analysis. Parents' knowledge, attitudes and behaviours toward myopia at the beginning and the end of the study will also be assessed.
Conclusion:
Delays in children's first myopia-related clinic visit appear to be common among parents in China, based on preliminary findings from hospital-based survey samples. Further systematic evaluation of large-scale myopia screening and health education initiatives is warranted to enhance their real-world effectiveness.
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