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Chris Andrews, Joshua D Stein, David C Musch, Rachel Schumann, Paul P Lee; Screening of Children for Eye Disease by Michigan Department of Community Health. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4501.
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To describe the extent of childhood eye screening programs conducted by the State of Michigan
Based on Michigan Public Health Code requirements, the State of Michigan Department of Community Health provides annual vision screening for school-age and preschool-age children in Michigan. The outcome of each screen is either a referral to an eye care professional or not. Data on vision screening were obtained from 45 Health Department agencies between 2001 and 2012. The percentage of all screens resulting in referral was calculated. Trends over time and comparison of rates among different ages and agencies were evaluated. Additional data from the US Department of the Census were used to estimate the number of children eligible for screening and to investigate associations between rates and demographic variables. Pre-school age was defined as 3 to 5 years; school age as 6 to 14 years.
Information was provided for 4,523,860 screens that resulted in 447,210 referrals (9.9%) over 11 years. 83% of all screens were of school age children. The Oakland County Health Agency reported the most screens (611,113), followed by Macomb, Kent, and Wayne. Six agencies reported fewer than 20,000 screens. In school year 2011-2012, 548,547 screens were conducted (85,968 in pre-school age children; 462,579 in school age children). Michigan has an estimated 1.51 million children between the ages of 3 and 14 (0.34 million pre-school age; 1.17 million school age). Approximately 362 screens were conducted per 1000 children (249 pre-school age; 396 school age). Agency screening rates varied from 127 to 627 per 1000 children. About 10% of screens resulted in referrals and this has remained relatively constant since 2006. Data prior to 2006 are incomplete from many agencies. There is substantial variation among agencies from above 20% to below 6%. The referral rate is higher among school age children than among preschool age children (11% vs. 7%). Graphical analysis of associations among screening rates and demographic variables at the agency level found only mild to moderate correlations.
The screening programs of the Michigan Department of Community Health referred nearly half a million children to eye care providers in the past decade. Even so, a substantial percentage of children do not receive annual screenings for eye disease. Underlying reasons for variation in screening rates will be described.
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