Preschool Vision Screening by Parental Risk Factor Questionnaire

视力障碍，如严重屈光不正、弱视和斜视，会影响发育中的视力。 2%至5%的学龄前儿童的教育系统。这些疾病导致视力下降的长期后遗症 早期发现和治疗可最大限度地减少(VA)和/或双眼视觉。虽然通过早期发现 对每一位婴幼儿进行全面的眼科检查是理想的，绝大多数婴幼儿 都没有严重的视力问题。将有限的医疗资源投向有问题的人 或通过视力筛查有可能发展为未来视力问题的人是更有理由和 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他们身上 提供给依赖视力一个或多个方面的直接测量的儿科医生和家庭从业者。 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。尽管它经常被使用，但它的功效 红色反射试验在筛查中尚未得到评价，使用时担心假阳性率高 由非眼科医生或8个月大的婴儿服用表明有明显的局限性。缺乏证据来支持 3岁以下儿童的常规视力筛查反映在美国预防疾病委员会2011年的建议中 服务特别工作组(USPSTF)，不包括2004年之前包括的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 目前对3岁以下儿童的视力筛查建议。迈向这一目标的第一步 此应用程序的目的是开发和验证风险因素筛选问卷，该问卷可以很容易地 由父母填写。问卷将把孩子分成三个类别之一，这三个类别将指导家长 1)尽快安排视力检查，2)安排训练有素的人员进行额外的筛查 使用现有/发展中的技术或3)推迟3至5岁的考试。已完成一个父项 问卷调查将减轻儿科医生和家庭目前面临的视力筛查时间负担 并将减少经常被提及的实施视力筛查的障碍之一 医生。这种有针对性的分级视力筛查方法将提高视力筛查的效率和准确性 我们目前的筛查工作往往很草率和零散。及早发现那些需要额外帮助的人 评估和/或护理，通过一个低成本或免费、可广泛获取、有效和可靠的问卷，将会有更多 有效利用紧张的医疗保健系统有限的人力和财力。

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.