Abstract
Aim: To analyse referrals from health visitors to a (secondary) orthoptic Children’s Vision Screening Clinic (CVSC) over a 5-year period, to assess whether a change in the type of testing, increase in age at testing, and also training from an orthoptist, had influenced the accuracy of testing and referrals. Methods: Data were collected from a departmental database to include a time span from 2 years prior to the changes to 2 years after implementation of operational changes. The changes were: (i) assessment at age 4 years instead of 3 years, (ii) visual acuity (VA) testing with a linear test instead of single optotypes and (iii) health visitor training on VA assessment. The referral reason and outcome of the visit to the CVSC were documented. Results: The results show that, over the 5-year period studied, similar proportions of children were being referred each year with the three most common vision problems. The number of false-positive referrals fell following the operational changes made in 2004, i.e., the accuracy of referrals increased: accurate (positive) referrals of children referred with reduced vision in one eye improved from 18% to 81% and those of children referred with reduced vision in both eyes increased from 35% to 75%. These differences were statistically significant. Conclusion: Changing to a linear test at an increased age of 4 years, along with regular teaching and updates, has had a beneficial effect on the quality of the referrals to the CVSC. To comply fully with national screening guidelines, further changes are needed and the service continues to evolve.
Highlights
Current guidelines in the United Kingdom for primary vision screening recommend a pre-school vision check for children aged 4–5 years, preferably administered byPrior to this report numerous different screening programmes existed in the UK, utilising a variety of different visual acuity (VA) charts, involving testing of children at varying ages and utilising an array of people to administer the screening.[2]In 2003, following the Hall Report, a bid to fund primary orthoptic vision screening in the Salisbury area was submitted to the local Primary Care Trust (PCT)
The results show that over the 5-year period similar proportions were being referred each year with the three main problems identified (Table 1)
A prior Health Technology Assessment (HTA) report published in 19976 recommended the National Screening Committee (NSC) consider halting existing vision screening programmes
Summary
In 2003, following the Hall Report, a bid to fund primary orthoptic vision screening in the Salisbury area was submitted to the local Primary Care Trust (PCT). After the publication of Hall Report, this approach was changed to involve VA testing at the slightly older age of 4 years, using a linear test (linear Sheridan Gardiner), in addition to assessing the corneal reflections as performed previously. This change in both age at testing and type of testing was implemented in late 2003. Training on the use of the linear vision test was given at this stage and annual teaching sessions and updates have been held since
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
