Hartmann E Eugenie, Bradford Geoffrey E, Chaplin P Kay Nottingham, Johnson Tammy, Kemper Alex R, Kim Sunnah, Marsh-Tootle Wendy
Department of Optometry, School of Optometry, University of Alabama, Birmingham, Alabama, USA.
Pediatrics. 2006 Feb;117(2):e226-37. doi: 10.1542/peds.2004-2809.
Visual disorders among preschool-aged children are common, yet screening is infrequent. The purpose of this project was to implement the vision screening recommendations proposed by the Maternal and Child Health Bureau and National Eye Institute Vision Screening in the Preschool Child Task Force: monocular visual acuity and stereopsis testing.
Four sites fully participated in the implementation of the task force recommendations with 3- and 4-year-old children. Two of the sites worked with primary care practices (testing performed by staff); 2 worked with community-based programs (testing performed by lay volunteers). Each site tracked number of children screened by age, as well as proportion testable, referred, and with documented follow-up evaluation.
Variations in implementation of the recommendations were observed. Successful screening among 3-year-olds ranged from 70% to 93%; referral rates were 1% to 41%, and follow-up rates were 29% to 100%. Successful screening among 4-year-olds ranged from 88% to 98%; referral rates were 2% to 40%, and follow-up rates were 41% to 100%. The proportion of 3-year-olds who were treated was significantly different between the community-based sites (n = 20) and the primary care sites (n = 2). Similarly, the proportion of 4-year-olds who were treated was significantly different between the community-based sites (n = 36) and the primary care sites (n = 11).
. The variability across pilot sites in numbers successfully screened and numbers referred suggests that all aspects of preschool vision screening need thorough review before the goal of universal preschool vision screening can be realized.
学龄前儿童视力障碍很常见，但筛查并不频繁。本项目的目的是实施母婴健康局和国家眼科研究所学龄前儿童视力筛查特别工作组提出的视力筛查建议：单眼视力和立体视觉测试。
四个地点全面参与了针对3岁和4岁儿童的特别工作组建议的实施工作。其中两个地点与初级保健机构合作（由工作人员进行测试）；另外两个地点与社区项目合作（由非专业志愿者进行测试）。每个地点按年龄跟踪筛查的儿童数量，以及可测试、转诊和有记录的后续评估的比例。
观察到建议实施情况存在差异。3岁儿童的成功筛查率在70%至93%之间；转诊率为1%至41%，后续跟进率为29%至100%。4岁儿童的成功筛查率在88%至98%之间；转诊率为2%至40%，后续跟进率为41%至100%。在接受治疗的3岁儿童比例上，社区项目地点（n = 20）和初级保健地点（n = 2）之间存在显著差异。同样，在接受治疗的4岁儿童比例上，社区项目地点（n = 36）和初级保健地点（n = 11）之间也存在显著差异。
试点地点在成功筛查人数和转诊人数方面的差异表明，在实现普及学龄前视力筛查目标之前，需要对学龄前视力筛查的各个方面进行全面审查。
