Vision screening in preschool children.

Madlom, M M

doi:10.1136/bmj.304.6821.253-a

Cited by 1 publication

(1 citation statement)

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“…52 While the debate on preschool vision screening continues, primary screening backed up by secondary orthoptic/optometric assessment has been shown to substantially decrease the number of inappropriate referrals to hospital clinics. 33,51,[53][54][55][56][57][58] Where this occurred, only 14% were referred to the hospital clinic, of whom 76% were referred back to the community for subsequent full or partial management. 54 Such schemes have also demonstrated that children are referred earlier for treatment (average age decreased from 6.6 years to 5 years) and that the relationship between social deprivation and the age of presentation of asymptomatic amblyopia is abolished.…”

Section: Discussionmentioning

confidence: 99%

The assessment and management of strabismus and amblyopia: a national audit

Wickham

Stewart

Charnock

et al. 2002

Eye

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Aims To determine what systems are in place within ophthalmic services for the assessment and management of children suspected of having amblyopia and strabismus. To find out what methods are used for the assessment of these children. Methods A questionnaire-based study auditing 288 orthoptic departments in the UK. Results Responses were received from 75% orthoptic departments. Most hospitals employ more than one system for the assessment of strabismus and amblyopia, which is generally dependent on route of referral. These include 'orthoptic assessment without refraction' (66%), 'combined orthoptist and ophthalmologist assessment' (66%), while 22% have an entirely orthoptist/optometric system.Ophthalmologists are involved in the initial assessment in 145 units (67%), whereas some units involve an ophthalmologist only if response to treatment is poor (15%), or if surgery is required (6%).Fourteen per cent of units reviewed all children, with discharge criteria being based on normal visual acuity (52%), accurate visual acuity (39%) and a normal orthoptic assessment (42%). Seventy-six per cent of units review some children, commonly as a result of family history (55%), parental concern (43%), poor co-operation (30%) and young age (72%). In the absence of squint or amblyopia children are discharged at the first visit, in only 8% of units.There is considerable variation in the tests used to assess visual acuity. LogMAR-based tests (eg EDTRS) are not routinely used in 75% of units. Conclusion Different systems exist for the assessment and management of squint and amblyopia across the country. While much of this variation is to be expected given their possible aetiologies, some could be reduced to produce a more cohesive service. There is also considerable scope for rationalising the tests used to screen infants and children for amblyopia and strabismus.

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