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2015-18 report

2015-18 report supplement (parents' questionnaires)

Peer-reviewed papers

Asare, A.O., Wong, A., Maurer, D., & Nishimura, M. Access to vision services by vulnerable populations in Canada: A scoping review. Journal of Health Care for the Poor and Underserved, 2019, 30, 6-27.

Nishimura, M., Wong, A., Cohen, A., Thorpe, K.E. & Maurer, D. Choosing appropriate tools and referral criteria for visual screening of 4- and 5-year-old children in Canada: a quantitative analysis. BMJ Open 2019;9:e032138. doi:10.1136/ bmjopen-2019-032138.

Nishimura, M., Wong, A., Dimaris, H., & Maurer, D. Feasibility of a school-based vision screening program to detect undiagnosed visual problems in kindergarten children in Ontario. Canadian Medical Association Journal, 2020, 192(29), E822-E831. CMAJ 2020 July 20;192:E822-31. doi: 10.1503/cmaj.191085

Main points of the last paper

  • Screening found for the first time in their lives that 7% of kindergarten children had an eye problem that could lead to blindness in one eye unless treatment began by age seven. Treatment started immediately, usually in the form of a pair of free glasses.

  • Most schools, teachers, and parents support vision screening in schools, and children say they enjoy the vision "games."

  • Screening takes 15 to 20 minutes per child and can be conducted for $10, including the cost of the equipment.

  • When parents received a letter permitting them to opt out of screening, 4% did so. When parents were required to opt in, 30% did not.

  • Referral rates to optometrists averaged 53% for children in junior kindergarten and 34% for children in senior kindergarten. Screening a child in both junior as well as senior kindergarten added no value.

  • Fifteen percent of the children we referred did not see our optometrist because they were already seeing another. Of the remaining children, 70% were taken by parents to the follow-up appointment we scheduled for them, no matter whether that appointment was in school or at the optometrist's office. The remaining 30% had parents who did not reply to our letter, or refused the appointment without giving a reason, or did not show up.

  • School-based vision screening can identify a large number of kindergarten children with treatable eye problems, but successful treatment depends on the parents' awareness of the importance of eye exams and glasses, their knowledge that eye exams are covered by OHIP, and the ready availability of free glasses if parents cannot pay for them.
Interview with Dr. Nishimura about these points at MedicalResearch.com.