Abstract
Purpose :
Studies show that the critical age for vision screening for detection of amblyogenic risk factors is between ages 3-5 though there is little evidence for compliance with screening recommendations. This prospective population-based study determined the compliance of parents with screening recommendations, and examined the relationship between ethnicity, gender, and compliance.
Methods :
Preventative care for children 0-6 years of age is given in Israel via Maternal Child Health Clinics (MCHC). Children ages of 3-5 in the Jerusalem District MCHC were invited for vision screening and examined by optometrists between 12/2017-07/2019. Each MCHC serves a homogeneous population that is either ultra-Orthodox (UO) or secular (S) Jewish or Arab (A). Exams included distance visual acuity (Lea chart, decimal units) and retinoscopy. Referral criteria were based on the APPOS guidelines. Parents were surveyed regarding follow-up, diagnoses, and treatments 6 months post screening. Screening failure and compliance rates were reported as proportions with 95% Confidence Intervals (CI). Compliance with referrals was analyzed using logistic regression.
Results :
A total of 2893 parents were called to schedule vision screening, and 1512 children were screened (52.3%, 95% CI 50.4-54.1%). Gender and ethnicity were not significantly associated with compliance. A total of 364 children (24.1%, 95%CI 21.9-26.3%) failed the screening and were referred to ophthalmology. The 6 month post screening survey demonstrated that 157 (43.1%) children underwent full eye examination and 35.6% of these had abnormal results. The average time between screening and full exam was 2.4±2.1 months (0.03±10 range). In contrast, 189 children (54.6%), were not taken for a full exam and three were lost to follow up. There was no difference in adherence between genders (48.9% vs. 40.0%, females and males, respectively, p=0.3). Arabs were more likely to adhere than Jews (60.9% vs. 41.9%, p<0.03) and there was no difference between UO and S Jews (41.7% vs. 42.3%, p=0.9). After adjustment for gender, the odds ratio for adherence between Jews and Arabs was 0.31 95%CI, 0.11-0.80.
Conclusions :
Half the parents brought their children in for vision screening. A quarter of children failed vision screening and only 43% were taken to a full eye exam. While adherence to ophthalmic care is low in Israel, the Arab minority may be more likely to comply with screening referrals.
This is a 2020 ARVO Annual Meeting abstract.