Clinical Outcomes of State Mandated Kindergarten Eye Examinations in a Suburban Ophthalmology Clinic
Noha S. Ekdawi, MD; Carolyn S. Oestrele, MD; Mathew Kipp; Michael A. Kipp, MD
Wheaton Eye Clinic
Introduction: The state of Illinois has required a screening by an optometrist or ophthalmologist prior to kindergarten since 2007. This requirement has allowed us to gather information regarding disease prevalence in a local population.
Methods: IRB approval was through Northwestern Medicine. A retrospective chart review was undertaken of kindergarten eye examinations performed at the Wheaton Eye Clinic between September 2008 and February 2017. Inclusion criteria included school eye examination as reason for visit and a cycloplegic refraction was completed. Data was collected regarding patient demographics, family history, past medical/birth history, all exam findings, and final diagnoses.
Results: Of 1131 patient charts identified, 676 satisfied the inclusion criteria, of which 49% were female. Historical characteristics showed 84 were premature, 20 patients were autistic and 52 were developmentally delayed. On examination, 147 had< 20/30 vision in either eye, 17 had refractive errors>+3.50 diopters and one<-3.00 diopters. Abnormal external exam finding was found in 135 while 14 had an abnormal fundus finding. Diagnoses included 9 as glaucoma suspects, 36 with amblyopia, 28 with anisometropia, 1 with esotropia, 4 with exotropia, 95 with phorias, and 13 with convergence insufficiency. 50%of the autistic children were diagnosed with ocular pathology. At the end of the examination, 49 patients were given glasses.
Discussion: Using the published criteria by Donahue, we found 8% had amblyopia risk factors compared to the 10% referral rate for photoscreening1. Glasses were given to 7.2% of the cohort, similar to Traboulsi et al2. Autistic children maybe more likely to have eye disorders.
Conclusion: Our rate of treatable ocular conditions discovered via state-mandated kindergarten eye examinations compares favorably to photoscreening and large scale screening programs.
References: 1. Bregman J, Donahue SP. Validation of photoscreening technology in the general pediatrics office: a prospective study. J AAPOS Off Publ Am Assoc Pediatr Ophthalmol Strabismus. 2016;20(2):153-158. 2. Griffith JF, Wilson R, Cimino HC, Patthoff M, Martin DF, Traboulsi EI. The Use of a Mobile Van for School Vision Screening: Results of 63 841 Evaluations. Am J Ophthalmol. 2016;163:108-114.