Screening Initiative Identifies Unmet Refractive Correction Needs in Children

A mobile vision screening program can assess refractive error and amblyopic risk factors for children and refer them for comprehensive eye examinations when necessary, according to a study published in Clinical Ophthalmology. The community screening initiative provides all services free of charge, according to the report. 

The mobile clinic, operated by the University of California Irvine, screened 5226 pediatric patients (mean age, 4.45 years) during the 2019-2020 school year. Trained associates performed the vision screenings and referred patients with hyperopia of +3.50 diopters (D) or more, myopia of -3.00 D or more, astigmatism of 1.50 D or more, or anisometropia of 1.00 D or more for clinical evaluation. Two pediatric optometrists performed comprehensive examinations when necessary and used cycloplegia at their discretion. 

A total of 546 children failed the vision screening and 350 among this group obtained caretaker consent and were examined. Subsequent evaluation revealed 8% of these participants had amblyopia (79% unilateral). A total of 246 (70.3%) of the children received refractive error correction. 

The optometrists performed cycloplegic refraction for 240 children. Among these patients, 43% had hyperopia, 30% had myopia, and 27% had emmetropia. 

Astigmatism was the most common amblyopic risk factor and was present in 64% of children with amblyopia (≥1.5 D). Other risk factors included hyperopia (20%), anisometropia (9%), and myopia (5%). 

“The importance of childhood vision care cannot be overstated, and vision screening programs like the UCI EyeMobile for Children are essential for identifying and treating visual disorders such as amblyopia and refractive error in at-risk children,” according to the researchers. “… our program identified a significant proportion of Orange County preschool children with refractive errors and amblyopia who were living with unmet needs for refractive correction.”

Study limitations include a retrospective nature and failure to use cycloplegic retinoscopy in all children referred for comprehensive exams.