Are all children with visual impairment known to the eye clinic?

Pilling, Rachel; Outhwaite, Louise

doi:10.1136/bjophthalmol-2016-308534

Cited by 15 publications

(19 citation statements)

References 7 publications

(12 reference statements)

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“…This is considerably lower than headline rates of cooperation reported by other studies [2,4,5]. Pilling [4] reported a rate of 97% cooperation with functional vision assessment which included the use of the Bradford box, a novel visual function instrument [18]. The rate of cooperation with standard tests (Crowded Keeler LogMAR, Crowded Kays pictures and Cardiff Acuity Test) was 62%, a similar proportion to that found in our evaluation.…”

Section: Discussionsupporting

confidence: 74%

“…Despite the availability of a wide range of visual acuity tests, a reliable measurement of visual acuity using established methods was only possible for 60.5% of children. This is considerably lower than headline rates of cooperation reported by other studies [2,4,5]. Pilling [4] reported a rate of 97% cooperation with functional vision assessment which included the use of the Bradford box, a novel visual function instrument [18].…”

Section: Discussionmentioning

confidence: 90%

“…Under the recommendations of the United Kingdom National Screening Committee [ 11 ], all children should have access to an orthoptic led screening of vision at school entry (age 4–5 years) primarily to identify amblyopia, but also refractive error and strabismus. However, it has been suggested that the provision of this type of screening, in special schools is patchy [ 5 ] and it is questionable if such screening is suitable for children with complex needs, given that many cannot be assessed using established visual acuity tools [ 4 ]. Studies [ 2 , 4 , 5 ] have also highlighted the low uptake of hospital eye care and primary care optometric eye examinations in community optical practices by the special schools population.…”

Section: Introductionmentioning

confidence: 99%

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Findings from an opt-in eye examination service in English special schools. Is vision screening effective for this population?

et al. 2019

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Our objective was to present the findings of an opt-in, school-based eye care service for children attending 11 special schools in England and use these findings to determine whether a vision screening programme would be appropriate for this population. Data from eye examinations provided to 949 pupils (mean age 10.7 years) was analysed to determine the prevalence and aetiology of visual deficiencies and reported eye care history. For 46.2% (n = 438) of pupils, a visual deficiency was recorded. 12.5% of all the children seen (n = 119) had a visual deficiency that was previously undiagnosed. Referral for a medical opinion was made for 3.1% (n = 29) of pupils seen by the service. Spectacle correction was needed for 31.5% (n = 299) of pupils; for 12.9% (122) these were prescribed for the first time. 3.7% (n = 11) of parents/carers of pupils needing spectacles chose not to use the spectacle dispensing service offered in school. Eye care history was available for 847 pupils (89.3%). Of the pupils for whom an eye care history was available, 44% (n = 373) reported no history of any previous eye care and10.7% (n = 91) reported a history of attending a community optical practice/opticians. Only one pupil from the school entry 4–5 age group (0.6% of age group n = 156) would have passed vision screening using current Public Health England screening guidelines. Children with a diagnosis of autism were significantly less likely to be able to provide a reliable measurement of visual acuity. This study supports previously published evidence of a very high prevalence of visual problems in children with the most complex needs and a significant unmet need in this group. It demonstrates routine school entry vision screening using current Public Health England guidelines is not appropriate for this group of children and very low uptake of community primary eye care services.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

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Findings from an opt-in eye examination service in English special schools. Is vision screening effective for this population?

et al. 2019

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“… 4 Certification takes place within Eye clinics and there is evidence of poor uptake of hospital eye care for children with significant visual needs. 10 …”

Section: Discussionmentioning

confidence: 99%

Is there evidence that the yearly numbers of children newly certified with sight impairment in England and Wales has increased between 1999/2000 and 2014/2015? A cross-sectional study

et al. 2017

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ObjectivesTo use routine data capture from hospitals in England and Wales to identify whether there has been an increase in the annual numbers of children newly certified sight impaired in England and Wales between 1999/2000 and 2014/2015 and to examine causes of certifiable sight impairment in children certified in 2014/2015.DesignA cross-sectional study including an analysis of all certificates of vision impairment completed in hospitals in England and Wales each year between 2007/2008 and 2014/2015 and all certificates completed in hospitals in England and Wales in 1999/2000.ParticipantsCertificates for all individuals aged 16 years or less at the time of certification in England and Wales for each financial year between 1 April 2007 and the 31 March 2015 and for individuals aged 15 years or less for the year ending 31 March 2000. We obtained information on the main cause of certifiable sight loss for all children certified in 2014/2015. We estimated crude and sex specific incidence estimates with 95% confidence intervals computed by Byars method.ResultsIn 1999/2000, the estimated incidence (95 % CI) of certification was 8.2 (7.7 to 8.8) per 1 00 000. In 2007/2008, the estimated incidence was statistically significantly higher at 10.1 (9.5 to 10.7). Since then a trend of increasing incidence with time has been observed until 2014/2015 when an estimated incidence of 13.3 (12.6 to 14.0) was observed. Hereditary retinal dystrophies, cerebral visual impairment and nystagmus were the most common single causes of certifiable sight impairment in children in 2014/2015.ConclusionOur findings show that in England and Wales there has been an increase in the number of children newly certified sight impaired by consultant ophthalmologists since 1999/2000. This mirrors our previous findings based on data originating within social service departments.

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“…This creates a compounding burden on already strained NHS services by increasing clinic waiting times and reducing the number of appointments available for new patients. Furthermore, it has been shown that children have a high 'did not attend (DNA)' rate at hospital clinics [21,22]. Provision of eyecare in-school allows for another child to be examined in lieu of any absentees, reducing the financial impact of missed appointments [23].…”

Section: In-school Servicementioning

confidence: 99%

Parents and teachers of children in special education settings value in-school eyecare and written reports of visual status

McConnell

Black²,

McClelland³

et al. 2020

PLoS ONE

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Objectives To evaluate parent and teacher opinion of the provision of in-school eyecare and jargon-free written reporting of visual status for children in special educational settings. Participants and methods A nationally-agreed, in-school eyecare framework for children attending special schools which recommends a full eye examination, dispensing of spectacles and provision of a jargon-free written report of visual outcomes to parents and teachers, was provided to 200 children (mean age 10 years, 9 months; 70% male) attending a special school in the UK. The written 'Vision Report' detailed, in lay-language, results from the eye examination and provided practical advice to alleviate the impact of vision difficulties both at home and in the classroom. Following implementation of the framework, parents and teachers completed a feedback questionnaire to determine their opinion of the in-school eye examination and utility of the Vision Report. Results Parents of 123 participants returned a feedback questionnaire. Eighty-eight participants were represented by the 23 teachers who returned a questionnaire. The in-school eyecare was rated positively for children in special education by 82.4% of parents and 80.9% of teachers. Key benefits included the familiarity of the in-school setting (81.3% of parents and 100% of teachers agree), the convenience of the setting for parents (74.0% of parents and 100% of teachers agree), and the opportunity for teachers to speak directly to eyecare providers regarding a child's visual needs (82.6% of teachers agree). The information provided by the Vision Report was deemed useful day-today by 78.3% of parents and 100% of

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Are all children with visual impairment known to the eye clinic?

Cited by 15 publications

References 7 publications

Findings from an opt-in eye examination service in English special schools. Is vision screening effective for this population?

Findings from an opt-in eye examination service in English special schools. Is vision screening effective for this population?

Is there evidence that the yearly numbers of children newly certified with sight impairment in England and Wales has increased between 1999/2000 and 2014/2015? A cross-sectional study

Parents and teachers of children in special education settings value in-school eyecare and written reports of visual status

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