Abstract
Follow up from universal vision screening at four to five years has been shown to be low in England, potentially increasing the risk of vision disorders not being treated. This study explores vision specialists’ views on the perceived barriers and facilitators encountered when engaging with parents and young children, and the strategies adopted to improve child/parent centred care. Fifteen semi-structured qualitative interviews were conducted with eye care professionals to explore perspectives on the challenges of treating children. Thematic analysis was performed to identify key barriers and the strategies eye care professionals adopt to enhance person-centred eye care when working with young children and their families. Two overarching themes were identified related to the professional-patient relationship. The first reflects the challenges which vision specialists experience when treating children, considering lack of eye health education and negative attitudes to diagnosis and treatment as major barriers. The second discusses the strategies adopted to tackle those barriers. Three strategies are proposed to enhance child-centred eye care: more eye health education, more personalised communication to enhance referral uptake and the development of better coordinated pathways of care between schools, communities and hospital services.
Highlights
Screening children’s vision at a young age is recommended to detect signs of potential disorders such as amblyopia, strabismus and refractive error, which can affect the child’s visual development
A recent study conducted in England (Bruce & Outhwaite 2013) found approximately 70% of children attended follow-up after school screening and the British and Irish Orthoptic Society (BIOS) 2016–17 audit of vision screening reports a mean attendance of 70% ranging widely from 27% to 95% (Griffiths et al 2018)
The low uptake of follow up for children vision care (Bruce & Outhwaite 2013), this study aimed to explore vision specialists’ views on the current model(s) of eye care and the perceived barriers and potential enablers to follow-up referrals and treatment when working with young children
Summary
Screening children’s vision at a young age is recommended to detect signs of potential disorders such as amblyopia, strabismus and refractive error, which can affect the child’s visual development. Treatment of reduced vision is important in children as treatment is age-sensitive and should be started as early as possible (de Zoete 2007). In the UK, the National Screening Committee (2013) recommends screening children aged four to five years for vision disorders by an orthoptist-led service. In England, vision screening is undertaken in the first year of school. A recent study conducted in England (Bruce & Outhwaite 2013) found approximately 70% of children attended follow-up after school screening and the British and Irish Orthoptic Society (BIOS) 2016–17 audit of vision screening reports a mean attendance of 70% ranging widely from 27% to 95% (Griffiths et al 2018)
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