Referral Outcomes from a Vision Screening Program for School-Aged Children

Abstract

Purpose : This study analyzed the ocular outcomes of children evaluated by the Wills Eye Vision Screening Program for Children (WEVSPC) who were referred to the Wills Eye Hospital Pediatric Ophthalmology Service due to subnormal best corrected visual acuity or the presence of other ocular concerns.

Methods : The WEVSPC screened students in grades K-5 enrolled in School District of Philadelphia public schools over a 2-year period. Children with suspected non-refractive ocular conditions were referred to the Pediatric Ophthalmology Service of Wills Eye Hospital. A Wills Eye pediatric social worker assisted the parents and guardians of referred children in scheduling an appointment and navigating insurance and payment issues. Each child’s ocular outcomes, including diagnoses and treatment plans, were reviewed and recorded following the eye examination.

Results : Between January 2014 and June 2015, 509 children, 4.7% of the 10,726 children screened, were referred to Wills Eye Hospital for a follow-up eye examination. A total of 127 of the 509 (25.0%) children completed their referral eye examination at Wills Eye Hospital. The majority of the children were African American (56.7%), Hispanic/Latino (17.3%), and Caucasian (15.0%). Most children (57.5%) were diagnosed with more than one eye condition. The most common ocular conditions were refractive error (75.6%), amblyopia (41.7%), strabismus (15.7%), and anisometropia (11.8%). Of the children with refractive errors, 36.5% had hyperopia ≥ +5.00, myopia ≥ -5.00, and/or astigmatism ≥ +3.00.

Conclusions : The WEVSPC detected and addressed eye disease in children susceptible to amblyopia by either ensuring children were already receiving eye care or offering social worker services and financial support to enable children to complete a referral eye examination. Significant and potentially vision-threatening conditions were diagnosed especially among underserved children. The completion rate of consent forms remains a challenge; without consent, the social worker cannot contact parents/guardians to assist with scheduling an eye exam and navigating the vision/health insurance system.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.