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The role of screening and surveillance in the detection of childhood vision impairment and blindness in the UK

Solebo, Ameenat Lola; Teoh, Lucinda; Rahi, Jugnoo Sangeeta; (2022) The role of screening and surveillance in the detection of childhood vision impairment and blindness in the UK. Archives of Disease in Childhood 10.1136/archdischild-2021-323470. (In press). Green open access

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Abstract

Objective: Understanding pathways to detection for childhood visual impairment (VI) is critical for planning services. We aimed to describe patterns of detection for childhood VI. // Design: and setting Cross-sectional study using data from British Childhood Visual Impairment and Blindness Study 2. // Patients: Children newly diagnosed with VI, severe vision impairment or blindness (SVI/BL)—that is, visual acuity worse than logMAR 0.5 in both eyes—were identified through active surveillance, with data collection at diagnosis and 1 year later. Outcome: measure Method of detection of vision/eyes problem. // Results: 784 children (45%, 356 girls) were identified, of whom 313 (40%) had VI, 471 (60%) had SVI/BL. Additional non-ophthalmic disorders or impairments (VI/SVI/BL ‘plus’), were diagnosed in 72% (559/784). Of the 784, 173 children were detected through routine screening (22%), 248 through targeted examinations (32%) and 280 through family self-referral (36%). Parents and carers had only reported symptoms in 55% of children who manifested them, with evidence that families living in socioeconomically deprived areas were less likely to report concerns. Paediatricians were the professionals most likely to raise initial suspicion of visual disability. // Conclusions: Our findings show that targeted screening and surveillance is important for the detection of full spectrum childhood visual impairment (VI/SVI/BL), as a significant proportion of children will not have symptoms, or their parents or carers will not report symptoms. As paediatricians were the professionals most commonly involved in detection, it would be helpful if their core competencies included the skills needed to undertake simple assessments of vision.

Type: Article
Title: The role of screening and surveillance in the detection of childhood vision impairment and blindness in the UK
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/archdischild-2021-323470
Publisher version: http://dx.doi.org/10.1136/archdischild-2021-323470
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10148881
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