Referral Outcomes from a Vision Screening Program for School-Aged Children
John Anhalt, MD; Marlee Silverstein, BA; Katelyn Scharf, BA; Eileen L. Mayro, BA; Melanie Snitzer, MSW, LSW, ACSW; Michael Pond, BA; Linda Siam, BS; Alex V. Levin, MD, MHSc
Wills Eye Hospital
Philadelphia, Pennsylvania, USA
Introduction: Community vision screening programs rely on appropriate care of identified ocular disease through pediatric ophthalmology referral and consultation to ensure successful correction of each student’s vision challenges.
Methods: We reviewed the referrals generated by our in-school vision screening program for children in grades K-5 in School District of Philadelphia public schools between January 2014 and June 2015. Children with subnormal best corrected visual acuity or other ocular conditions were referred to a pediatric ophthalmology service. A social worker assisted parents/guardians of referred children in scheduling an appointment and navigating insurance/payment issues.Â
Results: Of 10,726 children screened, 509 (4.7%) were referred for a follow-up eye examination. Of these 509 children, only 127 (25.0%) completed their referral eye examination. Most children (57.5%) were diagnosed with more than one eye condition. The most common ocular conditions were refractive error (75.6%), amblyopia (42.5%), strabismus (15.7%), and anisometropia (12.6%). Other conditions included macular hypoplasia, ptosis and other congenital anomalies.
Discussion: Our study illustrates the potential efficacy of a community based vision screening program to identify significant ocular pathology and connect affected students with pediatric ophthalmology consultation thereafter.
Conclusion: This program addressed potentially vision-threatening conditions in underserved children by offering social work services and financial support to enable children to complete a referral eye examination following a failed in school vision screening.
References: 1. Hark L, Mayro E, Schneider R, Torosian J, Tran J, Pond M, Snitzer M, Dabbish N, Levin AV: Improving access to vision screening in urban Philadelphia elementary schools. J AAPOS 2016;20(5):439-443
2. Pizzi LT, Snitzer M, Amos T, Prioli K, Steele D, Levin AV: Cost and effectiveness of an eye care adherence program for Philadelphia school children with significant visual impairment. Popul Health Manag 2015;18(3):223-31
3. Diao W, Patel J, Snitzer M, Pond M, Rabinowitz M, Ceron G, Dennis K, Weiner R, Martinez-Helfman S, Santa Maria K, Burke B, Aultman WB, Levin AV: The effectiveness of a mobile clinic in improving follow-up eye care for at-risk children. J Pediatr Ophthalmol Strabismus 2016;53(6):344-348