Comparison of open-ended and close-ended questions to determine signs and symptoms of eye problems among children / Comparación entre las preguntas con respuesta abierta y cerrada para determinar los signos y síntomas de los problemas oculares en los niños

BACKGROUND: Parents play important role in providing information regarding their children's health status to healthcare providers. However, parents' ability in reporting signs and symptoms of eye problems among their children required more in-depth investigation. Our study aimed to compare the differences of parental report regarding eye problems among their children using two different question approaches. METHODS: A total of 416 parents with children aged between two months old and 17 years old were participated in this cross-sectional survey. The responses of parents' observation on signs and symptoms of eye problems were compared between one open-ended question and ten close-ended questions. We also examined the demographic contributing factors that could influence parental responses. RESULTS: The total count of reported signs and symptoms through open-ended and close-ended question was 164 and 529 reports, respectively. Parents reported more diverse (70% higher) categories of signs and symptoms in open-ended compared to close-ended questions. Parent's ability to report eye problems using open-ended question was associated with their gender (p < 0.05), but no similar significant association was found in close-ended questions. CONCLUSIÓN: Parents reported more signs and symptoms of eye problems among their children through close-ended questions (regardless of gender) and more diversified categories through open-ended question in this study suggested that different communication approaches might be needed in clinical practice between those who requested specific appointment and those attending screening or routine assessment. The discrepancy might imply the importance to enhance the parent's role in preventive eye care. Effective communication between eyecare providers and parents has the potential to improve paediatric eyecare delivery

ANTECEDENTES: Los padres juegan un papel importante a la hora de suministrar información a los profesionales sanitarios, con relación a la situación sanitaria de sus hijos. Sin embargo, la capacidad de los padres para reportar los signos y síntomas de los problemas oculares de sus hijos requiere una investigación más profunda. El objetivo de nuestro estudio fue comparar las diferencias de los informes parentales sobre los problemas oculares de sus hijos, utilizando dos enfoques de preguntas diferentes. MÉTODOS: Un total de 416 padres con hijos de edades comprendidas entre dos meses y 17 años participaron en esta encuesta transversal. Las respuestas de la observación de los padres sobre los signos y síntomas de los problemas oculares fueron comparados utilizando una pregunta con respuesta abierta y diez preguntas con respuesta cerrada. También examinamos los factores contributivos demográficos que podrían influir en las respuestas parentales. RESULTADOS: El recuento total de los signos y síntomas reportados a través de las preguntas con respuesta abierta y cerrada fue de 164 y 529 informes, respectivamente. Los padres reportaron más categorías diversas de signos y síntomas en las preguntas con respuestas abiertas (un 70% más) que en las de respuestas cerradas. La capacidad de los padres para reportar los problemas oculares utilizando preguntas con respuestas abiertas guardó relación con el sexo (p < 0,05), aunque no se encontró una asociación similar significativa en las preguntas con respuesta cerrada. CONCLUSIÓN: En este estudio, los padres reportaron más signos y síntomas de problemas oculares entre sus hijos a través de preguntas con respuesta cerrada (independientemente del sexo), y más categorías diversificadas entre las preguntas con respuesta abierta, lo cual sugiere que podrían necesitarse diferentes enfoques de comunicación en la práctica clínica entre aquellos que solicitaron una cita específica y aquellos que asistieron a un cribado o a una evaluación rutinaria. La discrepancia podría implicar la importancia de resaltar el papel de los padres en los cuidados oculares preventivos. La comunicación efectiva entre los profesionales de atención ocular y los padres tiene el potencial de mejorar la prestación de atención ocular pediátrica

Comparison of the pediatric vision screening program in 18 countries across five continents.

PURPOSE: Incorporating mass pediatric vision screening programs as part of a national agenda can be challenging. This review assessed the implementation strategy of the existing pediatric vision screening program. METHODS: A search was performed on PubMed, EBSCO host MEDLINE Complete, and Scopus databases encompassing the past ten years for mass pediatric screening practice patterns that met the selection criteria regarding their objectives and implementation. Results were analyzed from 18 countries across five continents. RESULTS: Eight countries (44%) offered screening for distance visual acuity only, where the majority of the countries (88%) used either Snellen or Tumbling E chart. High-income countries initiated screening earlier and applied a more comprehensive approach, targeting conditions other than reduced vision only, compared with middle-income countries. Chart-based testing was most commonly performed, with only three countries incorporating an instrument-based approach. Lack of eyecare and healthcare practitioners frequently necessitated the involvement of non-eyecare personnel (94%) as a vision screener including parent, trained staff, and nurse. CONCLUSIONS: Implementation of a vision screening program was diverse within countries preceded by limited resources issues. Lack of professional eyecare practitioners implied the need to engage a lay screener. The limitation of existing tests to detect a broader range of visual problems at affordable cost advocated the urgent need for the development of an inexpensive and comprehensive screening tool.

Comparison on testability of visual acuity, stereo acuity and colour vision tests between children with learning disabilities and children without learning disabilities in government primary schools.

CONTEXT: Children with learning disabilities might have difficulties to communicate effectively and give reliable responses as required in various visual function testing procedures. AIMS: The purpose of this study was to compare the testability of visual acuity using the modified Early Treatment Diabetic Retinopathy Study (ETDRS) and Cambridge Crowding Cards, stereo acuity using Lang Stereo test II and Butterfly stereo tests and colour perception using Colour Vision Test Made Easy (CVTME) and Ishihara's Test for Colour Deficiency (Ishihara Test) between children in mainstream classes and children with learning disabilities in special education classes in government primary schools. MATERIALS AND METHODS: A total of 100 primary school children (50 children from mainstream classes and 50 children from special education classes) matched in age were recruited in this cross-sectional comparative study. The testability was determined by the percentage of children who were able to give reliable respond as required by the respective tests. 'Unable to test' was defined as inappropriate response or uncooperative despite best efforts of the screener. RESULTS: The testability of the modified ETDRS, Butterfly stereo test and Ishihara test for respective visual function tests were found lower among children in special education classes ( P < 0.001) but not in Cambridge Crowding Cards, Lang Stereo test II and CVTME. CONCLUSION: Non verbal or "matching" approaches were found to be more superior in testing visual functions in children with learning disabilities. Modifications of vision testing procedures are essential for children with learning disabilities.

Comparison of vision disorders between children in mainstream and special education classes in government primary schools in Malaysia.

INTRODUCTION: The visual status of children with learning disabilities has not been extensively studied. This study aimed to compare vision disorders between children in mainstream classes and those with learning disabilities attending special education classes in government primary schools in Malaysia. METHODS: In this cross-sectional comparative study, 60 school children (30 from mainstream classes and 30 from special education classes) who were matched in age (6-12 years old) and ethnicity (Malay, Chinese and Indian) were examined. The subjects were recruited using non-probability convenience sampling. A complete eye examination was performed to detect three major vision disorders, namely refractive error, lag of accommodation and convergence insufficiency. RESULTS: The overall prevalence of refractive error, lag of accommodation and convergence insufficiency was found to be 65.0%, 43.3% and 35.2%, respectively. Convergence insufficiency (χ² = 24.073, p < 0.001) was found to be associated with children in special education classes. No association was found between refractive error and lag of accommodation (p > 0.05) with the type of classes. CONCLUSION: Children in special education classes are more likely to have convergence insufficiency compared to children in mainstream classes. Thus, vision screening programmes for children in special education classes may need to be modified.