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，如严重屈光不正，弱视和斜视影响2%至5%学龄前儿童的视觉系统发育。通过早期发现和治疗，这些疾病的长期后遗症可以降低视力和/或双眼视力。虽然通过对每个婴儿进行全面的眼科检查来早期发现是理想的，但绝大多数婴幼儿并没有明显的视力问题。通过视力筛查，将有限的卫生保健资源用于有视力问题或未来有可能出现视力问题的人，是一种更合理、更可行的方法。目前，筛查学龄前儿童视力异常的主要责任落在儿科医生和家庭医生身上，他们依赖于对视力的一个或多个方面的直接测量。筛查指南建议在出生和6个月至1岁时检查眼睛健康和红色反射，并在3至3.5岁时增加VA和对准检查。尽管红色反射试验被广泛使用，但它在筛查中的效果尚未得到评估，并且当非眼科医生或小于8个月的婴儿使用时，对高假阳性率的担忧表明了显著的局限性。美国预防服务工作组（USPSTF） 2011年的建议排除了2004年建议中包括的3岁以下儿童的常规视力筛查，这反映了缺乏支持3岁以下儿童常规视力筛查的证据。本研究的长期目标是提供足够的证据来调整目前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份风险因素筛选问卷，该问卷可以由家长轻松完成。问卷将把儿童分为以下三种类型，指导家长：1)尽快安排眼科检查，2)安排训练有素的人员使用现有/正在发展的技术进行额外的筛查，或3)推迟在3至5岁时进行检查。家长填写的调查问卷将减轻目前儿科医生和家庭医生视力筛查的时间负担，并将减少忙碌的医生实施视力筛查时经常提到的障碍之一。这种有针对性和分层的视力筛查方法将提高我们目前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、广泛获取、有效和可靠的调查问卷，早期识别需要额外评估和/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。

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