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R. C. Allen, D. T. Wheeler, J. Vaughan; The Conundrum of a Mandated Comprehensive Eye Exam. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4353.
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One third of children under the age of 5 years old receive a vision screening examination and of those who undergo screening, one third may have an eye problem that is not detected on the first exam. This, in conjunction with the variable efficacy of the different state screening programs has been cause for concern. Thus some state legislatures have mandated a comprehensive eye examination for all children, and it has led other states such as Oregon to consider such legislation. However, in most instances the term comprehensive eye examination is not defined and it is not known how strictly practice guidelines are followed in this regard. The purpose of this study is to analyze the components of comprehensive pediatric eye examinations performed in the state of Oregon in reference to established practice guidelines.
A retrospective chart review study was conducted on 115 children who presented for a first time comprehensive eye examination to either an ophthalmologist or an optometrist after failing a standardized vision screening examination. Each chart was evaluated according to the criteria set forth by either the practice guidelines of the American Academy of Ophthalmology or the practice guidelines of the American Optometric Association respectively. The data was then analyzed by an independent corporation.
Of the 115 patients, 45 saw an ophthamologist and 70 saw an optometrist for their first exam. Of the 45 examinations performed by ophthalmologists, only 2% followed the practice guidelines of the American Academy of Ophthalmology in their entirety. Of the 70 examinations performed by optometrists, only 10% of the examinations followed practice guidelines completely.
Given the variability in comprehensive eye examinations in reference to established practice guidelines, the mandate of a comprehensive eye examination may not achieve the effect desired by its proponents.
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