title: Preschool vision screening in primary care pediatric practice.
abstract: OBJECTIVE
  We determined the efficacy of pediatric-based preschool vision screening, as knowledge of vision screening effectiveness in primary care pediatrics is incomplete.
  
  
  METHODS
  Pediatricians and staff at nine primary care pediatric practices were trained in vision screening, and practices screened children aged 3-5 years from May 2007 through July 2008. Children failing or considered untestable were referred for pediatric ophthalmology examinations. We determined rates of testability, failure, referral, and ophthalmologic examination completion, as well as positive predictive values (PPVs) of screening failure and untestability. We also surveyed practices to assess the ease and accuracy of preschool vision screening.
  
  
  RESULTS
  Of 2,933 children screened, 93 (3.2%) failed the vision screening and 349 (11.9%) were untestable. Untestability was highest (27.1%) among 3-year-olds. The PPV for failing any aspect of the vision screening was 66.7%; for children aged 3, 4, and 5 years, the PPVs for failing were 30.0%, 77.8%, and 87.5%, respectively. However, only 38.7% of children who failed the vision screening received ophthalmologic examinations, despite multiple follow-up attempts. Pediatricians rated the ease and accuracy of screening 3-year-old children lower than for screening older children.
  
  
  CONCLUSIONS
  Visual acuity-based screening had good PPV for vision loss for 4- and 5-year-old children but was less successful for 3-year-olds. Rates of referral and ophthalmologic examination completion were low, especially among children from low-income families.
authors: Eye Physicians of Central Florida, Maitland, FL 32751, USA. rhered74@gmail.com
authors: Robert W
authors: RW
authors: Hered
authors: David L
authors: DL
authors: Wood
mesh_terms: D000367:Age Factors; D002675:Child, Preschool; D005431:Florida; D006801:Humans; D010372:Pediatrics / Q000592:standards* / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011320:Primary Health Care / Q000592:standards* / Q000706:statistics & numerical data; D015397:Program Evaluation; D012017:Referral and Consultation / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D015351:Vision Screening / Q000379:methods / Q000592:standards*; D014792:Visual Acuity
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