Final Visual Outcomes and Treatment Received for Children Referred from a UK Primary School Visual Screening Program: A Comparison of An Orthoptic-led Program with Orthoptic-delivered Services

There is little published evidence relating to the final visual acuity of children who are identified as having reduced vision at a school screening program. The school vision screening program in Leeds (led by an orthoptist but delivered by health care support workers within the school nursing team) is examined.

Results: 7807 children were screened in school between November 1, 2013, and September 1, 2014. Of these, 319 (4%) failed the screen and were referred to the general optometry service and 547 (7%) were referred to the Children’s Community Eye Service (CCES). Of the children who were referred to the CCES, 79.4% attended their first appointment and 86.4% were positive referrals. Of the children with reduced vision, 31 (8.3%) were found to have a manifest strabismus or eye movement disorder; 75 (20% of the positive referrals) required occlusion therapy for amblyopia; 52.6% of those with initially reduced vision obtained good visual acuity following spectacle correction alone within an 18- to 24-week refractive adaptation period. Of those who completed their treatment, 92.9% had vision within normal limits for their age in both eyes at discharge. Of children referred from vision screening who were found to have a defect, 64.6% had that treatment completed within three visits.

Conclusion: Vision screening identifies individuals with treatable vision defects who have a greater than 90% chance of achieving normal visual acuity with good compliance to treatment. Vision screening programs led by an orthoptist but delivered by well-trained and monitored screeners can be of as good quality as a screening program delivered by orthoptists.