Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

1. A vision screening program for kindergarteners in Ontario, Canada diagnosed for the first time 7.2% of all screened children with a visual problem.

Evidence Rating Level: 2 (Good)

In Canada, around 20% of children between 3 and 6 years old have amblyopia or other clinically significant visual problems (such as hyperopia, myopia, and astigmatism). Despite its high prevalence, and eye examinations being covered by health insurance in Ontario, 86% of children younger than 6 have not been screened for visual problems. This is highly problematic, as the Canadian Pediatric Society recommends a minimum of 1 screening between 3 and 5 years of age, since treatments for amblyopia are most effective before 8 years of age. Should these issues be missed, visual disturbances may manifest as difficulties in schooling and infer implications to development longterm. In this prospective cohort study, the feasibility for implementing an early visual screening program in Ontario kindergartens was analyzed as a potential solution to this problem. Screening was conducted at 43 schools for 5884 children in junior kindergarten (age 4) and senior kindergarten (age 5). Those who did not pass the screening test were booked for an examination with an optometrist. The results showed that 68.9% of referred children attended the follow-up appointment, whether this was located at school or at the optometrist’s office. Overall, 10.7% of screened children were diagnosed with a visual problem, and for 67.2% of those diagnosed, it was their first eye examination. As well, 90.4% of the children had positive feelings about the vision games involved in the screening process. Overall, this intervention led to the first diagnosis of 7.2% of all screened children, though further research is needed to increase the rate of referred children attending follow-up examinations. Nonetheless, study findings suggest that in-school vision screening with follow-up eye examinations is an effective strategy for identifying at risk children early on, and may be used as a potential model for other locations. This study led to the implementation of a visual screening program for senior kindergarten students in Ontario.

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