Abstract
Introduction:Pre-school orthoptic vision screening (POVS) was implemented by the Scottish government and is a standardised assessment to promote early detection of visual problems in children. The target conditions are amblyopia, refractive errors and strabismus. We present the preliminary findings for the first three years of the screening program.Methods:The data from POVS was collected retrospectively. The data includes screening years 2013 to 2016 inclusive. Data was collected from each health board in Scotland. We report the coverage, referral rate, true positives and positive predictive values.Results:A total of 167,962 children were due to have vision screening over the 3 screening years included in this paper. This figure does not include the children that opted out of the eye test (mean opt-out rate 1.8%) and children that already attend the hospital eye service (mean already attend rate 3.1%). The POVS program had a mean coverage of 85.5%, ranging from 63.7% to 94.8% between health boards. Over the 3 year screening period, the mean referral rate was found to be 17.9%. The mean true positive rate was 88.9%, and the mean positive predictive value was 86.9%.Conclusion:The Scottish data set on pre-school orthoptic vision screening has shown excellent mean coverage. A consistently high true positive rate over the three screening years demonstrates it is a sensitive screening program, which is essential for the detection of visual problems in children.
Highlights
Pre-school orthoptic vision screening (POVS) was implemented by the Scottish government and is a standardised assessment to promote early detection of visual problems in children
Prior to the publication of the Hall 4 report, provision of vision screening varied between health boards, with some health boards having no screening in place, whilst others had orthoptic vision screening in place for over 30 years
A national orthoptic delivered pre-school vision screening service was introduced. This replaced the 39-month Health Visitor assessment of vision and the Orthoptist vision screening in Primary 1, which had been implemented in only some health boards in pervious years
Summary
Pre-school orthoptic vision screening (POVS) was implemented by the Scottish government and is a standardised assessment to promote early detection of visual problems in children. Pre-school orthoptic vision screening (POVS) has been undertaken in all Scottish (mainland) health boards since 2012. This is a whole population, orthoptist-delivered screening with full audit data. Guidance was published in 2005 on how best to apply the recommendations in Scotland (Howie 2005) It stated that “All children should be screened by an orthoptist in their pre-school year, between the ages of four and five years, removing the need for vision testing on school entry”. A national orthoptic delivered pre-school vision screening service was introduced This replaced the 39-month Health Visitor assessment of vision and the Orthoptist vision screening in Primary 1, which had been implemented in only some health boards in pervious years
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