Preschool Vision Screening by Parental Risk Factor Questionnaire

描述（由申请人提供）：视力障碍，如显著屈光不正、弱视和斜视，影响2 - 5%学龄前儿童的发育中的视觉系统。这些降低视力（VA）和/或双眼视力的疾病的长期后遗症可以通过早期检测和治疗来最大限度地减少。虽然通过对每个婴儿进行全面的眼科检查进行早期检测是理想的，但绝大多数婴儿和幼儿没有明显的视力问题。将有限的医疗资源用于视力有问题或将来有可能出现视力问题的人士，透过视力检查，是一个更合理和可行的方法。目前，筛查学龄前儿童视力异常福尔斯的主要责任落在儿科医生和家庭医生身上，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，并在3至3.5岁时将VA和对齐添加到筛查中。尽管其常用，但尚未评估红色反射试验在筛查中的有效性，并且当由非眼科医生或在< 8个月的婴儿中使用时，对高假阳性率的担忧表明存在显著的局限性。美国预防服务工作组（USPSTF）2011年的建议反映了缺乏证据支持3岁以下儿童的常规视力筛查，该建议排除了2004年建议中包含的3岁以下儿童。这项研究的长期目标是提供足够的证据，以调整目前对3岁以下儿童的视力筛查建议。实现这一目标的第一步和本应用程序的目的是开发和验证一个风险因素筛选问卷，可以很容易地由父母完成。调查问卷将儿童分为3类，指导父母：1）尽快安排眼科检查，2）由经过培训的人员使用现有/不断发展的技术安排额外的筛查，或3）推迟3至5岁的检查。家长填写的问卷将减轻目前视力筛查给儿科医生和家庭医生带来的时间负担，并将减少忙碌的医生实施视力筛查的一个经常提到的障碍。这种有针对性和分层的视力筛查方法将提高我们目前通常粗略和分散的筛查工作的效率和准确性。通过低成本或免费、广泛获得、有效和可靠的问卷，及早确定需要额外评估和/或护理的人，将更有效地利用紧张的卫生保健系统有限的人力和财政资源。

DESCRIPTION (provided by applicant): 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.