title: Ocular and visual status among children in special schools in Wales: the burden of unrecognised visual impairment.
abstract: OBJECTIVE
  The high prevalence of visual defects among children with special needs is well reported and guidelines for vision screening are in place. However, recent research has suggested that vision care for such children is neglected. This study set out to evaluate the current status of vision screening and eye care in special schools in Wales.
  
  
  METHODS
  In phase 1, all 44 special schools in Wales received a questionnaire on current vision screening practices. In phase 2, full eye examinations were conducted with 173 pupils of five schools with no screening service; the pupils were aged 2-21 years. In phase 3, feedback about the service was obtained from all schools and from 15 parents whose children took part.
  
  
  RESULTS
  In phase 1, vision screening was patchy and inconsistent among the 39 schools responding. In phase 2, there is a high proportion of pupils (42%) reporting no previous eye examination. Overall, 17% of the pupils in the five schools presented with low vision (WHO definition, poorer than 0.3 LogMAR), 50% needed a first-time or updated spectacle prescription and 51% had some ocular abnormality that was either sight-limiting or warranted action to prevent risk to sight. In phase 3, school staff and parents reported that school-based eye examinations were valuable and, for those children with previous experience, likely to be more successful than clinic-based or practice-based examinations for this particular population.
  
  
  CONCLUSIONS
  There is an urgent need for a school-based optometric service for this vulnerable group of children and young people.
authors.affiliation: School of Optometry & Vision Sciences, Cardiff University, Cardiff, UK.
authors.forename: J Margaret
authors.initials: JM
authors.lastname: Woodhouse
authors.affiliation: RNIB Cymru, Cardiff, UK.
authors.forename: Nathan
authors.initials: N
authors.lastname: Davies
authors.affiliation: School of Optometry & Vision Sciences, Cardiff University, Cardiff, UK.
authors.forename: Aideen
authors.initials: A
authors.lastname: McAvinchey
authors.affiliation: School of Optometry & Vision Sciences, Cardiff University, Cardiff, UK.
authors.forename: Barbara
authors.initials: B
authors.lastname: Ryan
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003695:Delivery of Health Care / Q000592:standards*; D004519:Education, Special; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012572:School Health Services / Q000592:standards*; D012574:Schools; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000175:diagnosis* / Q000453:epidemiology; D015351:Vision Screening / Q000592:standards*; D014792:Visual Acuity; D014852:Wales / Q000453:epidemiology; D055815:Young Adult
keywords: Refractive errors; Special needs; Vision screening; Visual defects