Prevalence of Comprehensive Eye Examination in Preschool Children With Eye Conditions

Introduction

The purpose of this study is to assess the prevalence of comprehensive eye examinations in multiethnic preschool children, including children with visually significant eye conditions, and identify factors associated with comprehensive eye examinations.

Methods

A sample of 9,197 African American, Hispanic, Asian American, and non-Hispanic White children aged 6-72 months was recruited for the Multi-Ethnic Pediatric Eye Disease Study from 2003 to 2011. Logistic regression performed in 2022 identified independent factors associated with parent-reported history of comprehensive eye examinations. The proportion of children with previous comprehensive eye examinations and the proportion with undetected amblyopia or strabismus were measured.

Results

The prevalence of comprehensive eye examinations was 6.3% overall and 38.3%, 24.8%, 19.1%, 15.1%, and 9.8% among children with strabismus, amblyopia, significant anisometropia, hyperopia, and astigmatism, respectively. Children without prior comprehensive eye examinations were more likely to have undetected amblyopia or strabismus than those with comprehensive eye examination history (ps<0.001). The prevalence of comprehensive eye examinations was higher among older children. Prevalence varied by race/ethnicity, with 8.1%, 7.9%, 6.3%, and 4.9% of non-Hispanic White, Asian American, African American, and Hispanic children having had prior comprehensive eye examinations, respectively; however, the differences did not remain after adjusting for other associated factors. Older age, a primary caregiver with a college/university degree or higher, having vision insurance, gestational age <33 weeks, neurodevelopmental disorder diagnosis, strabismus, and ocular disease history were all statistically significantly associated with a relatively higher prevalence of comprehensive eye examinations in multivariable analyses.

Conclusions

Comprehensive eye examinations were uncommon among preschool children, including those with treatable vision disorders. Interventions, such as parent education and vision insurance, are needed to imaprove comprehensive eye examination access and utilization for at-risk preschool children.

Parents' Awareness and Attitude Toward Pediatrics Eye Diseases in Makkah, Saudi Arabia: A Cross-Sectional Study

BACKGROUND

The necessity of early detection and parents' knowledge of pediatric eye conditions and eye care is crucial, not only because of the severe complications it can carry, like blindness, but also due to the availability of preventive measures and the importance of vision in a child's growth and social life. Therefore, this study aimed to evaluate the level of awareness of and attitudes toward children's eye diseases of parents in Makkah City, Saudi Arabia.

METHODS

 This descriptive, cross-sectional questionnaire-based study was conducted in Makkah, Saudi Arabia, from September to December 2022. A self-administered questionnaire was randomly distributed to fathers and mothers of children younger than 18 through social media platforms.

RESULTS

 A total of 470 parents who met the study's inclusion criteria completed the study questionnaire. The results showed that 72.8% of the parents had poor awareness of pediatric eye diseases, 24.5% had good awareness, and 2.8% had excellent awareness. With regard to the symptoms that might prompt parents to take their children to an eye specialist, eye redness had the highest percentage (24.5%). It was also shown that 68.5% would allow their children to undergo eye surgery, if necessary, while most of those who refused to do so (11.3%) cited fear of the surgical outcome as the cause of their refusal.

CONCLUSION

 Our study findings show inadequate parental knowledge about common pediatric eye diseases and eye care practices for children. Therefore, awareness and education programs targeting both parents are recommended to raise the parents' level of awareness of pediatric eye diseases and to improve their attitudes toward the same.

The Prevalence of Visual Impairment and Refractive Errors among a Youth Population in Mozambique: Evidence of the Need for Intervention

Visual impairment (VI) can significantly interfere in the child's daily activities and quality of life, having a negative effect on their development and learning. The aim of the study was to determine the prevalence of VI and associated demographic factors in students examined during the program "Moçambique te vejo melhor". This study was cross-sectional and retrospective, based on the 2018/19 edition of the program. Eye examinations were performed in secondary school students, aged between 12 and 20 years, of five districts in Nampula province. The examination included visual acuity, non-cycloplegic refraction and assessment of the anterior and posterior segment and ocular adnexa. The prevalence of uncorrected, presenting and best-corrected VI found was 18.3%, 10.8%, and 5.0%, respectively. Refractive error (RE) had a prevalence of 24.7%, and the age groups between 15-17 years and 18-20 years were significantly associated with myopia (with OR: 4.9 and OR: 8.8, respectively), as well as the 11th and 12th grade (OR: 8.1 and OR: 10.7, respectively), and Malema district had association with myopia (ORa: 0.4) and hyperopia (ORa: 0.4 and OR: 0.3) as a protective factor. The prevalence of RE and VI was relatively high, showing the need for greater intervention at the school level.

Quality of 2019 American optometric association clinical practice guideline for diabetic eye care

PURPOSE

The 2019 American Optometric Association (AOA) clinical practice guideline intends to assist optometrists in providing evidence-based eye care for people with diabetes. This technical report evaluated the methodological and reporting quality of the guideline.

METHODS

Four independent reviewers appraised the 2014 and 2019 versions of the AOA's guideline using the AGREE II instrument. Average scaled scores across the six domains of the AGREE II and an overall independent score were calculated based on the formula provided.

RESULTS

The 2019 guideline scored high (range: 75-93%) in all domains except for the domain of applicability (34%). In the domain of rigour of development, significant improvements were noted in the 2019 guideline (median score: 7.0, interquartile range (IQR): 6.0-7.0) compared to the 2014 guideline (median: 5.0, IQR: 4.0-6.0) (p < 0.0001). The appraisal of the guideline also identified room for further improvements, especially in relation to implementing the guideline.

CONCLUSION

The overall and domain specific quality of the AOA 2019 guideline was high, however, improvement in its applicability domain is required. The findings of this study will aid uptake of the guideline and inform improvement efforts for other international optometric guidelines.

The practise of paediatric optometry in a low-resource environment

BACKGROUND

The role of optometrists in paediatric visual assessment must compliment the role of other eye-care practitioners at all levels of care. This study was undertaken to determine if optometrists in Ghana screen, diagnose and manage paediatric ocular conditions (for example, strabismus, amblyopia), and further assessed if optometrists in Ghana have the requisite paediatric instrumentation in their practices.

METHODS

This was a cross-sectional descriptive survey involving optometrists in both public and private eye-care sectors in Ghana. A paediatric visual assessment questionnaire was sent to all registered optometrists in Ghana. The contents of the questionnaire evaluated areas of vision assessment, refraction, and previous diagnosis and management, which were matched with practice characteristics such as location, type of practice and type of employment. Chi-squared statistic was used to test associations between variables.

RESULTS

Responses were obtained from 140 optometrists out of the 326 registered optometrists, representing a response rate of 46 per cent. Overall, less than half of respondents (64 which represents 46 per cent) assessed themselves as practising full-scope paediatric eye care. These self-assessment views were more common among optometrists at the regional level (111: 79.3 per cent), followed by the district (20: 14.3 per cent) and sub-district levels (nine: 6.4 per cent) (χ² = 4.774, p < 0.05), but was not influenced by type of employment, type of practice and level of training (p > 0.05). In addition, the study revealed that many respondents were more likely to assess pre-schoolers' visual acuity (VA) (121: 96.0 per cent), do refraction (109: 88.6 per cent) and perform binocular vision (BV) assessment (93: 76.9 per cent) compared to the toddlers' VA (72: 55.4 per cent), refraction (57: 46 per cent) and BV assessment (68: 56.2 per cent).

CONCLUSION

Full-scope paediatric eye care services among optometrists in Ghana is limited.

Vision screening for children 1 to 5 years of age: US Preventive Services Task Force Recommendation statement

OBJECTIVE

The goal was to provide an update of the 2004 US Preventive Services Task Force (USPSTF) statement about screening for visual impairment in children <5 years of age.

METHODS

The USPSTF examined evidence on the association of screening for visual impairment in children 1 to 5 years of age with improved health outcomes, the accuracy of risk factor assessment and screening tests, the effectiveness of early detection and treatment, and the harms of screening and treatment.

RECOMMENDATION

The USPSTF recommends vision screening for all children at least once between the ages of 3 and 5 years, to detect the presence of amblyopia or its risk factors (grade B recommendation). The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of vision screening for children <3 years of age (I statement).