Comparing the effectiveness of vision screenings as part of the school entrance physical examination to comprehensive vision examinations in children ages 3 to 6: an exploratory study.

PURPOSE: The purpose of this exploratory study was to investigate the effectiveness of vision screenings performed during school entrance physical examinations compared with comprehensive vision examinations in the state of Kentucky, which mandates comprehensive eye examinations for children, ages 3 to 6, who are entering the public school system. METHODS AND SUBJECTS: In this exploratory study, 1,386 children had forms submitted from 36 optometrists and 1 ophthalmologist reporting on their vision and eye problems. Vision and eye problems were defined as the presence of strabismus, amblyopia, or a refractive error requiring an optical correction, as determined by the optometrists or ophthalmologist using cycloplegic refraction. Among these 1,386 children, there were 300 diagnosed with vision problems. RESULTS: Sixty-six children were diagnosed with a vision problem who had not previously been to an eye doctor and had received a vision screening at their school entrance physical examination. In 56 of these 66 children, the vision problem was not detected by the vision screening, according to the parents. CONCLUSION: The exploratory study suggests that comprehensive vision examinations may identify some vision problems that were not found in children's preschool physical examinations that included vision screenings. A larger randomized study is needed to determine the most appropriate method of timely diagnosis of vision problems in children that can be corrected with early intervention in order to ensure the vision health and well-being of children entering the public school system.

Vision examinations for all children entering public school--the new Kentucky law.

BACKGROUND: Kentucky was the first state in the United States to pass a law requiring an eye examination by an optometrist or ophthalmologist for each child entering public school, public preschool, or Head Start program for the first time. The law became effective on July 15, 2000. METHOD: Forty-three of 334 Kentucky Optometric Association members were surveyed by the Kentucky Optometric Association. They practiced in 37 of 120 counties throughout Kentucky. Eye examinations for 5,316 children entering the Kentucky school system for the first time were reviewed. The children were divided into groups of 3-year-olds, 4-year-olds, 5-year-olds, and 6-year-olds and older. The survey summarized data collected during the period of July 15, 2000 through April 1, 2001. RESULTS: Based on the survey of the clinical assessments of 5,316 eye examinations, a total of 740 children were prescribed spectacle lenses, 181 were diagnosed with amblyopia, 123 children were diagnosed with strabismus, and 44 were diagnosed with other eye diseases. Children in the 6-years-old and above age group were statistically prescribed more spectacle prescriptions than were children ages 3, 4, or 5 years of age. The number of spectacle lens prescriptions, strabismus, amblyopia, and eye diseases diagnosed was independent of county income levels. CONCLUSION: This survey of children entering the Kentucky public school system for the first time showed that 13.92% of the children were prescribed spectacle lenses, 3.40% were diagnosed with amblyopia, and 2.31% were diagnosed with strabismus.