title: [Are the ophthalmology items of the French health record realistic?].
abstract: OBJECTIVE
  Since 2006, French general practitioners have had to carry out an ophthalmological screening for children, using a methodology contained within the child's health record (carnet de santé). The purpose of this screening is to allow an early diagnosis of sight-threatening as well as potentially life-threatening conditions (e.g., retinoblastoma). The aim of the present study was to evaluate the theoretical knowledge and the clinical skills of practitioners implementing the screening, with regards to two specific items of the health record screening schedule, by means of a questionnaire.
  
  
  METHODS
  From December 2013 to September 2014, 42 practitioners (16 general practitioners, 14 pediatricians, 12 resident physicians) from four distinct locations in Normandy, France, were questioned using a questionnaire on two ophthalmological items of the French health record: one on red reflex and one on eyeball size.
  
  
  RESULTS
  Only four of 42 practitioners provided correct answers on the red reflex color. Thirty of 42 practitioners reported difficulties performing the red reflex test, mostly because they did not know the normality criteria and the purpose served by this test. Thirty-three of 42 practitioners declared that they found it difficult to know whether or not eyeball sizes were normal, mostly because they were unaware of the normality criteria. None of the practitioners provided the correct (to within ± 1 mm) mean horizontal cornea diameter in full-term newborns and adults.
  
  
  CONCLUSIONS
  This study demonstrates that there is poor theoretical knowledge and a low level of clinical skill for practitioners performing the ophthalmological screening based on the French health record schedule. This schedule therefore does not seem to meet its purpose.
authors.affiliation: Service d'ophtalmologie, CHU de Caen, avenue de la côte-de-nacre, 14032 Caen cedex 5, France.
authors.forename: P
authors.initials: P
authors.lastname: Saguet
authors.affiliation: Service d'ophtalmologie, CHU de Caen, avenue de la côte-de-nacre, 14032 Caen cedex 5, France.
authors.forename: A-L
authors.initials: AL
authors.lastname: Lux
authors.affiliation: Cabinet de médecine générale, rue de la Grâce-de-Dieu, 14610 Epron, France.
authors.forename: G
authors.initials: G
authors.lastname: Denion
authors.affiliation: Service d'ophtalmologie, CHU de Caen, avenue de la côte-de-nacre, 14032 Caen cedex 5, France; Inserm, unité 1075 Comète, 5, avenue de la côte-de-nacre, 14032 Caen, France; Unicaen, pôle de formations et de recherches en santé, 2, rue des Rochambelles, 14032 Caen cedex, France. Electronic address: edenion@wanadoo.fr.
authors.forename: E
authors.initials: E
authors.lastname: Denion
mesh_terms: D002983:Clinical Competence; D042241:Early Diagnosis; D005123:Eye / Q000033:anatomy & histology; D005128:Eye Diseases / Q000175:diagnosis*; D005602:France; D058005:General Practitioners; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008499:Medical Records; D015997:Neonatal Screening; D009887:Ophthalmoscopy; D010372:Pediatrics; D010818:Practice Patterns, Physicians'; D015351:Vision Screening