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.

视力障碍，例如明显的屈光不正，弱视和斜视影响正在发展的视觉 2至5％的学龄前儿童的系统。这些疾病的长期后遗症降解视力 （VA）和/或双眼视力可以通过早期检测和治疗最小化。同时通过 对每个婴儿的全面眼睛检查是理想的，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指向有问题的人 或者谁有通过视力筛选制定未来视力问题的人是一个更加理性的，并且 可实现的方法。目前，筛选视力异常的学龄前儿童的主要责任跌落 对于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从业人员来说。 筛查指南建议检查眼睛健康和出生时的红色反射，6个月至1岁 在3至3.5岁时，将VA和对齐方式添加到筛选中。尽管有共同用途，但 筛选中的红色反射测试尚未评估，并且使用时对高误报率的关注 通过非恐怖分子或在婴儿<8个月的婴儿中提出了显着局限性。缺乏支持证据 2011年美国预防建议反映了小于3的儿童的常规视觉筛查 服务工作组（USPSTF），不包括2004年以前包含的3个儿童 建议。这项研究的长期目标是提供足够的证据来重组 当前对不到3年儿童的视力筛查建议。朝着这个目标迈出的第一步 该应用程序的目的是开发和验证一个可以轻松的风险因素筛选问卷 由父母完成。问卷将分类儿童分为三个类别之一，这些类别将指导父母 至：1）尽快安排眼检查，2）安排训练有素的人员进行额外筛查 使用现有/不断发展的技术或3）在3至5岁时推迟考试。父母完成了 问卷将减轻目前对儿科医生和家人的时间负担视觉筛查 从业者，将减少经常被引用的障碍之一，以实施视力筛查 医师。这种有针对性和分层的视力筛选方法将提高 我们目前的，经常粗略的和分散的筛查工作。早期确定需要额外的人 评估和/或护理，通过低或无成本，可广泛访问，有效和可靠的问卷，将会更多 有效地利用紧张的医疗保健系统的人力和财务资源有限。