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Aim Methods Results Conclusions This study aimed to determine adherence with follow‐up from the New Zealand pre‐school vision screening programme. The study also examined associations between pre‐school vision screening outcomes and cognitive measures assessed at the 54‐month follow‐up in the Growing Up in New Zealand study cohort.A cross‐sectional retrospective record review of pre‐school vision screening outcomes and hospital ophthalmology records with linkage to Growing Up in New Zealand cohort study data.Of 176 children referred from vision screening, 21.6% did not attend a referral appointment. Of 138 children who attended a referral appointment, 21.0% did not attend one or more follow‐up appointments. Ethnic differences were observed in attendance at referral appointments (attended Māori 13%, Pacific 22.5%, European/Other 64.5%; not attended Māori 26.3%, Pacific 28.9%, European/Other 44.7%; P = 0.04) and follow‐up appointments (attended Māori 11.9%, Pacific 15.6%, European/Other 72.5%; not attended Māori 17.2%, Pacific 48.3%, European/Other 34.5%; P = 0.001). Vision screening outcome was significantly associated with letter naming fluency scores (P = 0.01) but not name and numbers scores (P = 0.05).Non‐attendance at referral and follow‐up appointments limits the efficacy of vision screening, particularly for children of Māori and Pacific ethnicity. Children referred from vision screening achieve lower scores on letter naming fluency, a key predictor of reading ability in later childhood. Equity‐based improvements are required to ensure that all children referred from vision screening receive appropriate follow‐up eye care. [ABSTRACT FROM AUTHOR]

Purpose: To survey paediatric eye care providers to identify current patterns of prescribing for hyperopia. Methods: Paediatric eye care providers were invited, via email, to participate in a survey to evaluate current age‐based refractive error prescribing practices. Questions were designed to determine which factors may influence the survey participant's prescribing pattern (e.g., patient's age, magnitude of hyperopia, patient's symptoms, heterophoria and stereopsis) and if the providers were to prescribe, how much hyperopic correction would they prescribe (e.g., full or partial prescription). The response distributions by profession (optometry and ophthalmology) were compared using the Kolmogorov–Smirnov cumulative distribution function test. Results: Responses were submitted by 738 participants regarding how they prescribe for their hyperopic patients. Most providers within each profession considered similar clinical factors when prescribing. The percentages of optometrists and ophthalmologists who reported considering the factor often differed significantly. Factors considered similarly by both optometrists and ophthalmologists were the presence of symptoms (98.0%, p = 0.14), presence of astigmatism and/or anisometropia (97.5%, p = 0.06) and the possibility of teasing (8.3%, p = 0.49). A wide range of prescribing was observed within each profession, with some providers reporting that they would prescribe for low levels of hyperopia while others reported that they would never prescribe. When prescribing for bilateral hyperopia in children with age‐normal visual acuity and no manifest deviation or symptoms, the threshold for prescribing decreased with age for both professions, with ophthalmologists typically prescribing 1.5–2 D less than optometrists. The threshold for prescribing also decreased for both optometrists and ophthalmologists when children had associated clinical factors (e.g., esophoria or reduced near visual function). Optometrists and ophthalmologists most commonly prescribed based on cycloplegic refraction, although optometrists most commonly prescribed based on both the manifest and cycloplegic refraction for children ≥7 years. Conclusion: Prescribing patterns for paediatric hyperopia vary significantly among eye care providers. [ABSTRACT FROM AUTHOR]

Purpose: Research suggests that there are challenges in the accessibility of eye care for children in England. This study explores the barriers and enablers to eye examinations for children under 5 years of age from the perspective of community optometrists in England. Methods: Optometrists working in community settings were invited to participate in virtual focus group discussions using an online platform based on a topic guide. The discussions were audio‐recorded, transcribed and thematically analysed. Themes were derived from the focus group data based on the study aim and research question. Results: Thirty optometrists participated in the focus group discussions. The overarching themes identified as barriers to eye examinations for young children in a community setting were as follows: 'Time and Money', 'Knowledge, Skills and Confidence', 'Awareness and Communication', 'Range of Attitudes' and 'Clinical Setting'. The key themes for enabling eye examinations for young children were as follows: 'Improving behaviour', 'Enhancing training and education', 'Enhancing eye care services', 'Raising awareness', 'Changes in professional bodies' and 'Balancing commercial pressures and health care'. Conclusion: Time, money, training and equipment are perceived by optometrists as key factors in providing an eye examination for a young child. This study identified a need for improved training and robust governance related to eye examinations for young children. There is a need for change within eye care service delivery such that all children, regardless of age and ability, are examined regularly, and by conducting these examinations, optometrists remain confident. [ABSTRACT FROM AUTHOR]

BACKGROUND: In 2012, Chicago Public Schools and the Chicago Department of Public Health partnered together to create the Chicago School‐Based Vision Program (CSBVP). This ongoing, city‐wide program provides school‐based vision services (eye examinations, eyeglasses provision, and eye care referrals) to students with limited access. METHODS: Descriptive analysis of the program operations from 2012 to 2020, including number of students served and exam findings during 2017‐2020, as well as lessons learned and recommendations for reproducing the successes of the CSBVP in other contexts. RESULTS: During its first 8 years, the CSBVP provided eye examinations to over 350,000 students. During the years 2017‐2020, this included 126,238 eye exams and provision of eyeglasses to 73,751 students. CONCLUSIONS: The CSBVP is built upon strong community and school relationships. The program offers vision services, equitably, to all students across the district. The lessons learned through the implementation of the CSBVP may provide guidance for future district‐wide vision programs. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to describe visual performance and the need for vision care services among Finnish older people receiving home care. We evaluated the applicability of the Resident Assessment Instrument of Home Care (RAI HC) in identifying visual impairment (VI) and the need for vision care services among older people. Design: A descriptive quantitative, cross‐sectional design. Methods: Visual impairment and the need for vision care services for older people receiving home care (N = 70) were determined by an optometrist's screening examination and vision assessment by home care workers using the RAI HC instrument. In this study, the definition of visual impairment was visual acuity (VA) <0.63 (logMAR >0.2). Results: According to the distance VA measurements, 41% of the participants showed VI (<0.63) of the better eye, while the RAI HC assessment revealed VI among 36% of the participants. The Kappa value for interrater reliability in classifying VI was 0.137. The optometrist's vision screening examination recognized a previously unknown and unmet need for vision care services more than twice as often as the RAI HC assessment. [ABSTRACT FROM AUTHOR]

Purpose: Treatments for myopia progression are now available, but implementing these into clinical practice will place a burden on the eye care workforce. This study estimated the full‐time equivalent (FTE) workforce required to implement myopia control treatments in the UK and Ireland. Methods: To estimate the number of 6‐ to 21‐year‐olds with myopia, two models utilising separate data sources were developed. The examination‐based model used: (1) the number of primary care eye examinations conducted annually and (2) the proportion of these that are for myopic young people. The prevalence‐based model used epidemiological data on the age‐specific prevalence of myopia. The proportion of myopic young people progressing ≥0.25 dioptres (D)/year or ≥0.50 D/year was obtained from Irish electronic health records and the recommended review schedule from clinical management guidelines. Results: Using the examination and prevalence models, respectively, the estimated number of young people with myopia was 2,469,943 and 2,235,713. The extra workforce required to provide comprehensive myopia management for this target population was estimated at 226–317 FTE at the 0.50 D/year threshold and 433–630 FTE at the 0.25 D/year threshold. Extra visits required for myopia control treatment represented approximately 2.6% of current primary eye care examinations versus 13.6% of hospital examinations. Conclusions: Implementing new myopia control treatments in primary care settings over the medium‐term is unlikely to overwhelm the eye care workforce completely. Further increases to workforce, upskilling of current workforce and tools to reduce chair time will help to ensure sustainability of the eye care workforce into the future. [ABSTRACT FROM AUTHOR]

Purpose: The World Health Organization is developing a Package of Eye Care Interventions (PECI) to support the integration of eye health care into national health programmes. Interventions included in the PECI should be based on robust evidence where available. Refractive error is a leading cause of blindness and vision impairment and is a PECI priority condition. The aim of this study was to provide high‐quality evidence to support the development of the PECI by identifying and critically appraising clinical practice guidelines (CPGs), and extracting recommendations for refractive error interventions. Methods: We searched for CPGs on refractive error published in the last 10 years. We conducted the searches initially in February and March 2019 and repeated them in March 2020. We evaluated the quality of potentially relevant guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool. Results: We identified 12 high‐quality CPGs relevant to refractive error, written by six organisations from three high‐income countries. Organisations used a variety of frameworks to assess the strength of recommendations based on available evidence, with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) being most common. Vision screening for children aged 3 to 5 years was recommended consistently. Evidence for screening and eye evaluations at other ages was weaker, although ophthalmic professional organisations consistently recommended regular evaluations. Recommendations on optical and laser correction of refractive error were limited and did not consider implications for low resource settings. Interventions for slowing myopia progression in children were recommended, but these will need regular updating as new evidence emerges. Conclusions: Current high‐quality guidelines on refractive error have been formulated in high‐income countries. Recommendations focused on prevention and treatment of refractive error in low‐and middle‐income countries are lacking. Regular updating of systematic reviews and CPGs is essential to ensure that robust evidence is promptly appraised and incorporated into recommendations for eye health care practitioners. [ABSTRACT FROM AUTHOR]

Purpose: Good vision during childhood is vital for visual, educational, and social development. Previous research highlights challenges in the accessibility of eye care for children. This study investigates the accessibility of primary eye care for young children with typical development and those with autism in England. Methods: A telephone survey was conducted using four hypothetical scenarios (a child aged 1, 3, 5 years and a 13‐year‐old with autism). Four hundred community optometric practices (100 different practices for each scenario) were contacted to explore the availability of an eye examination. The caller acted as a parent, asking about the availability of an eye examination for their child and raising concerns regarding the child. Key barriers and enablers to the accessibility of primary eye care were identified through an analysis of qualitative information. Results: Of the 400 practices, only three (<1%) stated that they do not perform eye examinations on children. Fifty‐six practices (14%) stated that they would examine a child at any age, the remainder (n = 341, 85%) specifying a minimum age at which they would perform eye examinations on children. Lack of 'communication' from the child and 'equipment' were identified as barriers to accessing eye care for young children. Eye care for children with autism was enabled by factors related to adaptability and appointment time. Conclusion: Our results suggest that communication and a lack of appropriate equipment for examining children are potential barriers to accessing primary eye care. No clear barriers were identified for an older child with autism. Eye examinations are more accessible for older children in these scenarios (aged 5 with typical development and 13 years with autism) than younger children (aged 1 and 3 years old). While the UK General Ophthalmic Services (GOS) terms do not permit contract holders to exclude categories of patients from a GOS eye exam, our findings suggest this is taking place. [ABSTRACT FROM AUTHOR]

Purpose: The prevalence of depression in people with low vision is high and often goes undiagnosed. There is the potential for those who provide low vision services to perform concurrent depression screening. However, prior training in depression identification and suitable referral pathways is required. The aims of this study were: (1) to assess the impact of a training programme on practitioners' confidence and behaviour in addressing depression in patients with low vision, and (2) to review the training programme and identify areas for further development. Methods: A convergent mixed methods approach was used. Questionnaires were completed by practitioners pre‐, immediately post‐ and 6 months post‐ training (n = 40) to assess practitioner confidence in approaching depression in patients with low vision. Qualitative interviews were performed with a subset of practitioners 6 months post‐training (n = 9). Additionally, routine data from the Low Vision Service Wales (LVSW) database was used to determine the change in the number of practitioners identifying depression in patients, and the change in the number of patients identified at risk of depression 6 months post‐training. Results: Of the 148 practitioners who completed low vision assessments pre‐ and post‐training, 28 (18.9%) documented risk of depression in their patients pre‐training, which increased substantially to 65 (43.9%) post‐training (p < 0.0001). Mixed methods analysis confirmed increased documentation of depressive symptoms by practitioners. Practitioner confidence increased following training, with 92.3% feeling more confident to approach emotional issues with patients and 92.2% intending to use the recommended screening tool to identify depression. Interviews provided insight into areas where confidence was still lacking. Quantitative questionnaires revealed that training content was considered appropriate by 91% of participants. Interviews confirmed these findings while expanding upon possibilities for programme improvement. Conclusions: Training for depression screening was found to be time‐efficient and acceptable for LVSW practitioners and shown to increase practitioner confidence in the identification of depression. Additionally, the programme changed behaviour, resulting in an increase in the identification of depression in patients with low vision. However, this is a complex topic and ongoing development is required to embed depression screening as an integral part of low vision services. [ABSTRACT FROM AUTHOR]