Initial Results of a Statewide Preschool Vision Screening Program Based on the PUPVS Screening Recommendations

Abstract

Abstract: : Purpose: To report the initial results from a statewide preschool vision screening program utilizing the Project Universal Preschool Vision Screening (PUPVS) / Matern Child Health Bureau (MCHB) Task Force recommendations developed in 2000 and describe the challenges we encountered in maintaining a successful community–based preschool vision screening program. Methods: Between February, 2002 and August, 2004 8171 children ages 36–59 months were screened using a modified version of the Lea Symbols eye chart and the Random Dot E (RDE) stereoacuity cards. Screening was conducted by specially trained employees from a variety of community organizations throughout West Virginia involved in early childhood education and healthcare, including Head Start personnel, day care providers and primary care physicians and nurses. Families of children who failed the screening were called, sent information on pediatric vision disorders and referred to local ophthalmologists and optometrists for complete exams. Exam results were forwarded to our outreach program center. Results: 5849 (72%) preschoolers passed the vision screen. 1566 (19%) children failed either the Lea Symbols test or the RDE stereo test. 772 (9%) children were untestable. Of those who failed, 275 (18%) had results of their complete eye exam returned to our outreach center. Conclusions: Developing and maintaining a large scale preschool vision screening program has many challenges. An effective training program, utilizing adult pedagogy, must be developed to teach screening methodology to both healthcare workers and nonmedical personnel, who must be motivated to perform the screening. A re–certification protocol must be in place to maintain skills. Developmentally appropriate screening tests with high sensitivity and specificity must be utilized. Community ophthalmologists and optometrists must embrace the screening and participate in accurate, complete data collection. Parent education must address the importance of early screening and the need for follow–up after a failed screen. To be successful, vision screening programs must build extensive partnerships with existing community programs to disseminate the screening protocol, have a central office with leadership to coordinate activities and maintain a research database, and develop stable financial support from local, state and federal agencies and foundations.

Keywords: amblyopia • strabismus: diagnosis and detection