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: 8706880
• 负责人: RUTH E MANNY
• 金额: $ 20.04万
• 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 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8706880
• 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

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.

描述（由申请人提供）：视力障碍，例如重大屈光不正，弱视和斜视影响2至5％的学龄前儿童的视觉系统。这些条件的长期后遗症可以通过早期检测和治疗来最大程度地降低视力（VA）和/或双眼视力。虽然通过对每个婴儿进行全面检查的早期检测是理想的，但绝大多数婴儿和幼儿没有明显的视力问题。将有限的医疗保健资源引导到有问题或有可能通过视力筛查出现未来视力问题的人是一种更加理性和可实现的方法。目前，对视力异常进行筛查的学龄前儿童的主要责任落在了依靠视力的一个或多个方面的直接测量的儿科医生和家庭医生。筛查指南表明，出生时检查眼睛健康和红色反射，在3至3.5岁时将VA的6个月至1岁的筛选添加到筛查中。尽管使用了普遍的使用，但尚未评估红色反射测试在筛查中的功效，并且当非恐怖分子医生或婴儿使用<8个月的婴儿使用时，对高误报率的关注表明有显着局限性。在2011年美国预防服务工作组（USPSTF）的建议中，缺乏支持少于3名儿童的常规视觉筛查的证据反映出，该建议不包括2004年推荐中先前包括的3个儿童。这项研究的长期目的是提供足够的证据来重组当前的不到3岁儿童的视力筛查建议。朝着这个目标迈进的第一步，该应用程序的目的是开发和验证父母可以轻松完成的风险因素筛选问卷。问卷将分类儿童分为三个类别之一，这些类别将指导父母到：1）尽快安排眼科检查，2）使用现有/不断发展的技术安排培训人员进行额外筛查，或者3）在3至5岁时推迟考试。父母完成的问卷将减轻目前对儿科医生和家庭从业人员的时间负担远景筛查，并将减少忙碌的医生在实施视力筛查的经常引用的障碍之一。这种有针对性和分层的视力筛选方法将提高我们当前的粗略和分散筛查工作的效率和准确性。通过低成本或无成本（广泛访问，有效且可靠的问卷）对需要额外评估和/或护理的人们的早期识别将更有效地利用紧张的医疗保健系统的有限人力和财务资源。

项目成果

Excess Transforming Growth Factor-α Changed the Cell Properties of Corneal Epithelium and Stroma.

过量的转化生长因子-α 改变了角膜上皮和基质的细胞特性。

• DOI: 10.1167/iovs.61.8.20
• 发表时间: 2020
• 期刊: Investigative ophthalmology & visual science
• 影响因子: 4.4
• 作者: Zhang,Lingling;Yuan,Yong;Yeh,Lung-Kun;Dong,Fei;Zhang,Jianhua;Okada,Yuka;Kao,WinstonWY;Liu,Chia-Yang;Zhang,Yujin
• 通讯作者: Zhang,Yujin