Traboulsi Elias I, Cimino Heather, Mash Constance, Wilson Rhonda, Crowe Susan, Lewis Hilel
Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Trans Am Ophthalmol Soc. 2008;106:179-85; discussion 185-6.
The Vision First program began in the fall of 2002 as a community outreach initiative by the Cleveland Clinic Cole Eye Institute in partnership with the Cleveland Metropolitan School District. It was designed to provide free eye examinations to all prekindergarten, kindergarten, and first grade students enrolled in Cleveland City public schools in order to diagnose refractive errors, amblyopia, and strabismus, so that treatment is instituted and the best possible visual outcome attained.
Examinations are performed in 2 lanes of a specially outfitted recreational vehicle. All children undergo monocular visual acuity testing at distance and near, stereopsis testing, cover testing at distance and near, testing of versions, and external ocular inspection. If a child fails any part of this examination according to the guidelines set by the American Academy of Pediatrics, cycloplegic drops are instilled and an optometrist refracts the child on location and performs indirect ophthalmoscopy. Glasses are prescribed and follow-up with a pediatric ophthamologist is arranged.
During the first 4 years of the program, 22,988 examinations were performed. Seven percent of children had errors of refraction that necessitated optical correction, about 2.1% had strabismus, and 1.7% had amblyopia. The cost per student per year was around $23 excluding glasses.
About 10% of 5- and 6-year-old schoolchildren have eye problems that require either glasses or treatment for strabismus or amblyopia. The Vision First model brings eye care professionals to the schools and provides effective comprehensive screening of all children, as well as detailed examination and referral of those with significant eye problems.
“视觉第一”项目始于2002年秋季，是克利夫兰诊所科尔眼科研究所与克利夫兰市学区合作开展的一项社区外展倡议活动。该项目旨在为所有就读于克利夫兰市公立学校的学前班、幼儿园和一年级学生提供免费眼部检查，以诊断屈光不正、弱视和斜视，从而进行治疗并获得最佳视觉效果。
检查在一辆经过特殊装备的休闲车内的两条通道进行。所有儿童都要接受远近距离单眼视力测试、立体视测试、远近距离遮盖测试、眼位测试以及眼部外观检查。如果儿童根据美国儿科学会制定的指导方针在这项检查的任何部分不合格，就会滴入睫状肌麻痹眼药水，验光师在现场为儿童验光并进行间接检眼镜检查。开具眼镜处方并安排由小儿眼科医生进行随访。
在该项目的前4年中，共进行了22988次检查。7%的儿童有需要光学矫正的屈光不正，约2.1%的儿童有斜视，1.7%的儿童有弱视。每名学生每年的费用约为23美元（不包括眼镜）。
5至6岁的学童中约有10%存在需要配镜或治疗斜视或弱视的眼部问题。“视觉第一”模式将眼科护理专业人员带到学校，为所有儿童提供有效的全面筛查，以及对有严重眼部问题的儿童进行详细检查和转诊。
