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.

严重屈光不正、弱视和斜视等视力障碍会影响视力发育 2%至5%的学龄前儿童。这些导致视力下降的长期后遗症 (VA) 和/或双眼视力可以通过早期发现和治疗来最小化。虽然通过早期发现 对每个婴儿进行全面的眼部检查是最理想的，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 或者通过视力筛查有可能出现未来视力问题的人是一个更合理和更合理的选择。 可实现的方法。目前，筛查学龄前儿童视力异常的主要责任落在了 依赖于直接测量视力的一个或多个方面的儿科医生和家庭医生。 筛查指南建议在出生时和 6 个月至 1 岁时检查眼睛健康状况和红反射 在 3 至 3.5 岁时将 VA 和排列添加到筛查中。尽管它的用途很普遍，但它的功效 红色反射测试在筛查中的作用尚未得到评估，并且担心使用时假阳性率较高 由非眼科医生或小于 8 个月的婴儿进行的评估表明存在显着的局限性。缺乏证据支持 美国预防医学会 2011 年的建议反映了 3 岁以下儿童的常规视力筛查 服务工作组 (USPSTF) 将 3 岁以下儿童排除在外，此前已纳入 2004 年的计划 建议。本研究的长期目标是为重组提供足够的证据 目前针对 3 岁以下儿童的视力筛查建议。实现这一目标的第一步 该应用程序的目的是开发和验证可以轻松使用的风险因素筛查问卷 由家长完成。调查问卷将把孩子分为三类之一，以指导家长 目的：1) 尽快安排眼科检查，2) 安排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 岁的检查。家长已完成 调查问卷将减轻目前视力筛查给儿科医生和家庭带来的时间负担 从业者，将减少忙碌的人实施视力筛查时经常提到的障碍之一 医生。这种有针对性的分层视力筛查方法将提高视力筛查的效率和准确性 我们目前的筛选工作往往是粗略和分散的。及早识别那些需要额外帮助的人 通过低成本或免费、可广泛获取、有效且可靠的调查问卷进行评估和/或护理，将更多 有效利用紧张的医疗体系有限的人力和财力。