Wang Y D, Thompson J R, Goulstine D B, Rosenthal A R
Department of Ophthalmology, Leicester Royal Infirmary.
Br J Ophthalmol. 1990 Nov;74(11):650-3. doi: 10.1136/bjo.74.11.650.
We report on a survey of the referral of 525 children making their first visit to an ophthalmology department. Information was gathered by interviewing the parents and reviewing the case notes. Parents and relatives initiated the referrals in 223 cases (42%) and health visitors initiated a further 123 cases (23%). General practitioners were rarely the first to notice a condition, though they played a major part in the subsequent referral process. Of 556 reasons for referral squint was the most important (319 cases, 57%), followed by poor vision (106 cases, 19%). There were 44 confirmed cases of amblyopia, of which 15 (34%) were not detected until the child was aged 5 years or over. The overall accuracy of referral was 66% (367 reasons for referral confirmed). In 109 cases (21%) the child was found to be normal. Parents and relatives first noticed 54% of cases of confirmed squint but only 15% of the cases of poor vision. Health professionals, especially health visitors, were of great importance in first detecting poor vision.
我们报告了一项对525名首次前往眼科就诊儿童的转诊情况调查。通过与家长面谈并查阅病历收集信息。家长和亲属发起转诊的有223例（42%），健康访视员发起转诊的有123例（23%）。全科医生很少是首先发现病情的人，不过他们在后续的转诊过程中发挥了主要作用。在556个转诊原因中，斜视最为重要（319例，57%），其次是视力差（106例，19%）。有44例确诊为弱视，其中15例（34%）直到孩子5岁及以上才被发现。转诊的总体准确率为66%（367个转诊原因得到确诊）。在109例（21%）中，发现孩子正常。家长和亲属首先注意到54%的确诊斜视病例，但仅注意到15%的视力差病例。卫生专业人员，尤其是健康访视员，在首次发现视力差方面非常重要。
