ABSTRACT
PURPOSE: To investigate the potential of a mobile ophthalmic unit in the schoolyard to improve the follow-up rate for children who have failed an optometric in-school screening program. Previously, the optometric program made referrals to the center and only 53% of students attended the desired ophthalmology consultation. METHODS: This was a cohort study of students conducted in elementary school lots in socioeconomically disadvantaged communities. The mobile ophthalmic unit visited schools where students with parental consent who needed examination had been identified by an in-school optometric vision care program. RESULTS: A total of 132 students were referred by the optometric program, of whom 95 (72%) had complete signed consent forms. Eighty-two patients (62%, confidence interval: 54% to 70%) were successfully seen by the mobile unit. Compared to the historical rate of successful completion of ophthalmology consultation (53%), a statistically significant improvement in follow-up was noted (P = .036). On a Likert scale of 1 to 5, the mean school nurse satisfaction rating was 4.8. CONCLUSIONS: The findings demonstrate the potential impact of mobile eye clinics at schools in connecting children with ophthalmic care. [J Pediatr Ophthalmol Strabismus. 2016;53(6):344-348.].
Subject(s)
Continuity of Patient Care/organization & administration , Delivery of Health Care/organization & administration , Mobile Health Units/statistics & numerical data , Ophthalmology/organization & administration , Adolescent , Aftercare , Child , Child, Preschool , Cohort Studies , Community-Institutional Relations , Female , Health Services Needs and Demand , Humans , Infant , Male , Philadelphia , Refractive Errors/diagnosis , School Nursing/organization & administration , Vision ScreeningABSTRACT
PURPOSE: The Philadelphia Eagle Eye Mobile (EEM) provides optometric vision care to children who fail a vision screening performed by nurses at schools in low-income areas. METHODS: Data for children seen on the EEM between 2006 and 2008 for whom school nurse feedback was available regarding glasses wear at 1-, 4-, and 12-month intervals served as the study population. Optometric findings and glasses prescriptions at initial examination were recorded in the EEM database. The ophthalmic records for children referred for pediatric ophthalmology consultation at our institution were reviewed and those who did not attend were counted. RESULTS: A random subset of 689 students at 28 different schools at which follow-up forms were distributed to the school nurses regarding glasses wear was studied. This represents 10.8% of 6,365 children screened at 131 public schools visited by the EEM during that period. False-positive rates of school nurse screening averaged 16.11% (0% to 44%) for 689 children from 28 schools. Glasses compliance was 71% at 12 months and correlated to higher prescriptions. Only 53% of children attended their pediatric ophthalmology referral. CONCLUSIONS: Nurse training to reduce false-positive screening and strategies to improve attendance at arranged pediatric ophthalmologist consultations are recommended. The EEM effectively gets glasses to students where needed and use rates are satisfactory.