Abstract
Purpose: :
To evaluate the Massachusetts Preschool Vision Screening Program two years after implementation.
Methods: :
Following a legislative mandate, the Massachusetts Preschool Vision Screening Program was developed, based on a "medical home" model where preschool children receive vision screening by the primary care provider. In addition, the school nurses provided a backup support system. Working in collaboration with the Massachusetts Department of Public Health, an aggressive state-wide educational campaign was developed and targeted to pediatric primary care providers and school nurses. Two years after initiation of the program, a randomized phone survey of 100 primary care pediatric practices was conducted. In addition, a mail survey of pediatric healthcare providers was conducted in both 2005 and 2007. Comparative data was able to be obtained. An on-line survey tool inquiring about both the frequency and quality of vision screening was developed and targeted to school nurses; data was reported for 29,811 preschool children. Additional school nurse information was obtained on nearly 11,000 enrolled kindergarten students from a self-selected cohort of nurse leaders.
Results: :
Ninety nine percent of the primary care physicians contacted in the randomized phone survey indicated that they were aware of the new mandated preschool vision screening program and 89% reported that they were implementing the program. The mail survey from 2007 showed a significant increase in the number of physicians who reported use of the mandated vision screening protocol compared with 2005: picture symbol use declined and HOTV/Lea symbol use increased from 18% to 65%. Stereo testing, part of the recommended protocol, increased from 15% to 85%. 65% reported using recommended methods of ocular occlusion compared with 11% at baseline. Results from the school nurse surveys showed an increase in the number of preschoolers screened by primary care providers, from 44% in 2005 to 62% in 2007.
Conclusions: :
Two years after the Massachusetts Preschool Vision Screening Program was initiated, there has been an increase in both the rates and quality of preschool vision screening.
Keywords: amblyopia • visual development