Preschool Vision Screening by Parental Risk Factor Questionnaire

通过家长危险因素问卷进行学前视力筛查

• 批准号: 8583846
• 负责人: RUTH E MANNY
• 金额: $ 18.01万
• 依托单位: UNIVERSITY OF HOUSTON
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8583846
• 关键词: 1 year old; 3 year old; Academy; Adult; Advisory Committees; Age; Amblyopia; American; Asthenopia; Betula Genus; Binocular Vision; Birth; Caring; Categories; Child; Childhood; Clinical Trials Design; Development; Diplopia; Early Diagnosis; Early identification; Early treatment; Eye; Eye diseases; Family; Fern Tests; Future; Goals; Guidelines; Health; Healthcare; Healthcare Systems; Healthy People 2020; Human Resources; Infant; Interview; Literature; Measurement; Methods; Motor; National Eye Institute; Nursery Schools; Ophthalmic examination and evaluation; Parents; Pediatrics; Physicians; Preschool Child; Preventive; Questionnaires; Recommendation; Reflex action; Refractive Errors; Reporting; Research; Resources; Review Literature; Risk; Risk Factors; Sampling; Sampling Studies; Schedule; Services; Speed; Strabismus; Technology; Testing; Time; Training; Triage; United States Dept. of Health and Human Services; Vision; Vision Disorders; Vision Screening; Visual Acuity; Visual system structure; age group; care seeking; cost; disability; falls; improved; novel strategies; pediatrician; population based; public health relevance; screening; success; tool

Vision disorders such as significant refractive errors, amblyopia, and strabismus impact the developing visual system of 2 to 5% of preschool children. The long-term sequelae of these conditions that degrade visual acuity (VA) and/or binocular vision can be minimized by early detection and treatment. While early detection through a comprehensive eye examination of every infant is the ideal, the vast majority of infants and young children are without significant vision problems. Directing the limited health care resources towards those with problems or who are at risk for developing future vision problems through vision screening is a more reasoned and attainable approach. Currently, the primary responsibility for screening preschoolers for vision anomalies falls to pediatricians and family practitioners who rely on the direct measurement of one or more aspects of vision. Screening guidelines suggest inspection of eye health and red reflex at birth and 6 months to 1 year of age with VA and alignment added to the screening at age 3 to 3.5 years. Despite its common use, the efficacy of the red reflex test in screening has not been evaluated and concern over high false positive rates when used by non-ophthalmologist or in infants < 8 months suggest significant limitations. The lack of evidence to support routine vision screening in children less than 3 is reflected in the 2011 recommendations of the US Preventive Services Task Force (USPSTF) that excludes children less than 3 previously included in the 2004 recommendations. The long-term objective of this research is to provide sufficient evidence to restructure the current vision screening recommendations for children less than 3 years. The first step towards this goal and the aim of this application is to develop and validate a risk factors screening questionnaire that can be easily completed by a parent. The questionnaire will triage children into one of 3 categories that will direct the parent to: 1) schedule an eye examination as soon as possible, 2) schedule additional screening by trained personnel using existing/evolving technologies or 3) defer examination at age 3 to 5 years. A parent completed questionnaire will ease the time burden vision screening currently places on pediatricians and family practitioners and will reduce one of the often cited barriers to implementing vision screening by busy physicians. This targeted and tiered approach to vision screening will improve the efficiency and accuracy of our current, often cursory and fragmented, screening efforts. Early identification of those in need of additional assessment and/or care, through a low or no cost, widely accessible, valid and reliable questionnaire, will more effectively utilize the limited manpower and financial resources of the strained health care system.

视觉障碍，如显著的屈光不正、弱视和斜视，影响发育中的视觉发育。 学龄前儿童的2%至5%。这些情况的长期后遗症会降低视力 (VA)和/或双眼视觉可以通过早期检测和治疗而最小化。虽然早期检测通过 对每一个婴幼儿进行全面的眼科检查是理想的，绝大多数婴幼儿 没有严重的视力问题。将有限的医疗资源用于有问题的人 或有风险发展为未来视力问题的人通过视力筛查是一个更合理的， 可实现的方法。目前，筛查学龄前儿童视力异常的主要责任由福尔斯 儿科医生和家庭医生，他们依赖于直接测量视力的一个或多个方面。 筛查指南建议在出生时和6个月至1岁时检查眼睛健康和红色反射 在3至3.5岁时将VA和对齐添加到筛查中。尽管它的普遍使用， 在筛选中的红色反射试验尚未被评估，且当使用时，其存在高假阳性率的问题 非眼科医生或8个月以下的婴儿提示明显的局限性。缺乏证据支持 2011年，美国预防医学会建议对3岁以下儿童进行常规视力筛查， 服务工作队（USPSTF），不包括以前在2004年包括的3岁以下儿童 建议.这项研究的长期目标是提供足够的证据来重组 目前的视力筛查建议为3岁以下的儿童。实现这一目标的第一步， 该应用程序的目的是开发和验证风险因素筛选问卷， 由父母完成。调查问卷将把孩子分为3类，这将指导父母 目的：1）尽快安排眼部检查，2）安排由经过培训的人员进行额外筛查 使用现有/不断发展的技术或3）推迟3至5年的考试。家长完成 问卷调查将减轻视力筛查目前对儿科医生和家庭的时间负担 实践者，并将减少一个经常提到的障碍，实施视力筛查的忙碌 医生这种有针对性和分层的视力筛查方法将提高视力筛查的效率和准确性。 我们目前的，往往是粗略和零散的，筛选工作。及早确定需要额外援助的人 评估和/或护理，通过低成本或免费，广泛获得，有效和可靠的问卷，将更多 有效利用紧张的医疗系统有限的人力和财力。