Vision screening in prep-school aged children in Queensland: Outcomes of the Primary School Nurse Health Readiness Program

Abstract

Purpose: To report the outcomes of vision screening in prep-aged school children through the Primary School Nurse Health Readiness Program in Queensland, Australia. Methods: A retrospective review of vision screening records from January 2017 to December 2020 was undertaken. Vision screening through a unique dual-examination method, using the Parr 4 visual acuity chart and the Welch Allyn SPOT photoscreener, was offered to all prep-aged school children across Queensland. Based on a referral algorithm, those with a visual acuity of <6/9-2 in one or both eyes or a failed photoscreener test were referred to an optometrist or ophthalmologist for review. Positive predictive values were calculated based on whether a visual abnormality, including refractive error, strabismus, anisometropia and/or amblyopia, was confirmed through a formal eye assessment by an ophthalmologist or optometrist. Results: Of 185,685 eligible children, 176,164 (94.4%) consented to vision screening. A total of 164,890 (93.6%) children underwent vision screening, which ranged between 93.3% to 99.1% across all hospital and health services in Queensland. A total of 12148 (7.4%) children failed screening and were referred for an eye assessment and 6011 (49.5%) had a confirmed visual abnormality. The positive predictive value was 0.73 when a referral was indicated by the photoscreener result only, 0.76 when indicated by visual acuity only and 0.91 when indicated by both the photoscreener and visual acuity. Conclusions: The Primary School Nurse Health Readiness Program vision screening program showed a very high uptake among targeted school children and was highly effective in identifying potential visual problems with higher accuracy when the visual acuity and photoscreener results were used in conjunction.L6366696382021-12-27 <br />