Preschool Vision Screening: A Survey of University–Based Primary Care Physicians

Abstract

Abstract: : Purpose:Timely pediatric vision screening can reduce the incidence of amblyopia. However, a national study found that only 21% of preschool children were screened in the primary care setting¹. We surveyed university–based primary care physicians (PCPs) to ascertain their understanding of pediatric eye disease and vision screening practices. Methods:With institutional review board approval, 105 questionnaires were anonymously distributed to residents and faculty of the pediatric (Peds) and family practice (FP) departments at WVU. 10 items solicited knowledge of pediatric vision disorders and vision screening practices; 1 item pertained to PCP attitudes about vision screening. Results:12 Peds faculty members (29%), 10 Peds residents (36%), 7 FP faculty members (47%) and 7 FP practice residents (35%) responded. Fewer than 30% of residents and 60% of faculty recalled the anatomic abnormality in amblyopia is located in the visual cortex. 86% of respondents were unaware that the sailboat visual acuity chart is not approved by the American Academy of Pediatrics. 44% believed that preschoolers should be screened at 20 feet. 66% believed they are inadequately trained to screen vision of preschoolers, 36% believed vision screening takes too much time, 18% believed preschoolers are uncooperative for vision screening, and 11% believed they receive inadequate reimbursement to screen vision. A score of 70% for the 10 item questionnaire was determined as passing. The average scores for each group were: Peds residents 58%, Peds faculty 58%, FP faculty 51%, and FP residents 44%. Conclusions:Results among university–based physicians support results from a prior study done with community–based PCPs in West Virginia². Many PCPs appear to be unaware of AAP–approved vision screening tests. Many believe they are inadequately trained and reimbursed to screen vision. Improving education, training, and access to appropriate vision screening methods in residency programs may increase knowledge about pediatric eye disease and vision screening practices.References: ¹Ehrlich, M I, Reinecke, R D, Simons, K. Preschool vision screening for amblyopia and strabismus. Programs, methods, guidelines, 1983. Survey of Ophthalmology, 28:145–163. ²Bradford, G.E., P. Nottingham Chaplin, J.V. Odom. Preschool Vision Screening Practices by Primary Care Physicians in West Virginia. 2003 ARVO poster presentation.

Keywords: amblyopia • visual acuity • strabismus: diagnosis and detection