Routine ophthalmic follow-up screening for preterm infants - Where are we in Australasia?

Abstract

Purpose: Recent reports show that up to 40% of very preterm infants develop a variety of ophthalmic problems by 6.5 years of age. Outpatient ophthalmic follow-up screening for these conditions is therefore commonly offered. This study aims to describe this practice across Australia and New Zealand with a long term view to developing a standardised Australasian guideline. Methods: A structured questionnaire was developed and pilot-tested prior to distribution to all paediatric ophthalmology specialists across Australasia. Further information was gathered from the Australian and New Zealand Neonatal Network. Data was subsequently analysed both quantitatively and qualitatively. Results: 23 responses from the major paediatric ophthalmology centres across Australasia were received. 91% of respondents conduct routine ophthalmic follow-up. There was significant variation in inclusion criteria, number of screens performed, timing of first and subsequent screens, and types of visual assessments conducted at each screen. The majority (62%) of clinicians used birth-weight and/or gestational-age cut-offs for inclusion, and most commonly (40%), two screening visits were conducted. 40% of infants were first seen at 9 to <12 months corrected-age. For all visits, a combined ophthalmologist and orthoptist/optometrist team was involved (70%) with a visual acuity/orthoptic/cycloplegic refraction and dilated fundal assessment being performed in most cases (72%). Qualitative feedback was received highlighting the lack of adequate funding for screening. Conclusion: Although the vast majority of paediatric ophthalmologists across Australasia carry out ophthalmic follow-up screening for preterm infants, a wide variation in practice was identified. The burden of screening is significant and requires a costeffective evaluation.L6192847882017-11-21 <br />