Ekdawi Noha, Kipp Michael A, Kipp Matthew P
Wheaton Eye Clinic, Ltd., Wheaton, IL, USA.
Clin Ophthalmol. 2021 Mar 29;15:1331-1337. doi: 10.2147/OPTH.S300725. eCollection 2021.
The state of Illinois has required an examination by an optometrist or ophthalmologist prior to mandatory kindergarten since 2008. This requirement has allowed us to gather information regarding disease prevalence in a local suburban population.
A retrospective chart review was undertaken of kindergarten eye examinations performed at the Wheaton Eye Clinic between September 2008 and February 2017. Inclusion criteria included school eye examination as a reason for the visit, and a cycloplegic refraction was completed.
Of 3612 patient charts identified, 1085 satisfied the inclusion criteria, of which 48% were female. The average age of the patients was 5.3 years (range, 3.8 to 6.7). Historical characteristics showed 143 (13%) were premature, 28 (3%) patients were autistic and 109 (10%) were developmentally delayed. On examination, 56 (5%) had <20/40 (WHO mild visual impairment) vision in better seeing eye, 34 (3%) had spherical equivalent refractive error in either eye > +3.50 diopters and one < -3.00 diopters. Fifty-eight patients (5%) were diagnosed with amblyopia and 101 patients (9.3%) were given glasses. Abnormal external exam finding was found in 218 (20%) while 16 (1.5%) had an abnormal fundus finding. Thirteen percent (146/1085) had a clinically relevant diagnosis in our examinations, with a cost of $1635/diagnosis. In total, our follow-up rate was 83% (78/94).
Our rate of treatable ocular conditions discovered via state-mandated kindergarten eye examinations is similar to large-scale screening programs. The cost per condition found with full examinations was substantially higher; however, follow-up was more consistent.
自2008年以来，伊利诺伊州要求在强制入学幼儿园之前进行验光师或眼科医生检查。这一要求使我们能够收集有关当地郊区人口疾病患病率的信息。
对2008年9月至2017年2月在惠顿眼科诊所进行的幼儿园眼部检查进行回顾性病历审查。纳入标准包括以学校眼部检查为就诊原因，并完成了睫状肌麻痹验光。
在确定的3612份患者病历中，1085份符合纳入标准，其中48%为女性。患者的平均年龄为5.3岁（范围为3.8至6.7岁）。病史特征显示，143例（13%）早产，28例（3%）患者患有自闭症，109例（10%）发育迟缓。检查发现，56例（5%）较好眼视力<20/40（世界卫生组织轻度视力损害），34例（3%）任何一只眼的等效球镜屈光不正>+3.50屈光度，1例<-3.00屈光度。58例患者（5%）被诊断为弱视，101例患者（9.3%）配镜。218例（20%）发现外部检查异常，16例（1.5%）发现眼底异常。13%（146/1085）在我们的检查中有临床相关诊断，诊断费用为1635美元/例。总体而言，我们的随访率为83%（78/94）。
通过州强制要求的幼儿园眼部检查发现的可治疗眼部疾病发生率与大规模筛查项目相似。全面检查发现的每种疾病的成本要高得多；然而，随访更加一致。
