Trained nurses and laypersons perform well as preschool vision screeners

(2005-07-31)

Trained nurses and laypersons can be as adept at conducting vision screenings of preschoolers as optometrists and ophthalmologists according to the results of a recent study published in the August 2005 issue of Investigative Ophthalmology & Visual Science (IOVS). Their performance was also comparable to that of eyecare professionals using similar screening tools.

Researchers affiliated with the Vision in Preschoolers (VIP) Study measured the accuracy of vision screenings conducted by trained nurses and laypersons over a period of one year. A sample group of over 1,400 children three to five years old enrolled in Head Start programs were screened using the Retinomax Autorefractor, the SureSight Vision Screener, and two forms of the Linear Lea Symbols VA Test. Conditions targeted for identification were amblyopia, strabismus, significant refractive error, and reduced visual acuity in the absence of amblyogenic conditions. The screenings were conducted at Head Start program facilities.

The study, funded by the National Eye Institute (NEI), showed that the 43 VIP Study-trained nurses and laypersons using the Retinomax Autorefractor and the Suresight Vision Screener conducted screenings with the same degree of accuracy as optometrists and ophthalmologists. The Lea Symbols Visual Acuity (VA) screenings produced more accurate results when administered by an optometrist or ophthalmologist. However, when the format of the test was changed to present isolated, crowded Lea Symbols at a closer distance, laypersons were as accurate as the eyecare professionals using the original test, in which a line of symbols was presented.

"We are excited to have identified the best-performing tools for vision screening of preschool children, and to have found that trained lay screeners and nurses can use those tools effectively," said Paul A.

Sieving, M.D., Ph.D., director of the NEI. "As early detection of childhood eye disease increases the likelihood of successful treatment, these results have important implications for the visual health of children."

"Our results show that with sufficient training, both nurses and laypersons can administer the vision screening tests that the VIP Study has established as most viable for preschool children," said Paulette Schmidt, OD, MS, Chair of the VIP Study.

The VIP Study is a prospective, multi-center, clinical study to determine the accuracy of tests to screen for vision disorders among preschool children enrolled in Head Start. The Study's participating institutions are University of California, Berkeley School of Optometry, Berkeley, Calif.; New England College of Optometry, Boston, Mass; University of Pennsylvania, Philadelphia, Pa.; The Ohio State University College of Optometry, Columbus, Ohio; Oklahoma Northeastern State University College of Optometry, Tahlequah, Okla.; and The Pennsylvania College of Optometry, Philadelphia, Pa.

IOVS is published by the Association for Research in Vision and Ophthalmology (ARVO). IOVS, available monthly in print and online, is ranked #1 by ISI among primary research journals in ophthalmology. For more information, logon to www.IOVS.org. You can read this article online in at iovs.org/cgi/content/full/46/8/2639.

ARVO is a membership organization of more than 11,300 eye and vision researchers from over 70 countries. Established in 1928, the Association encourages and assists its members and others in research, training, publication and dissemination of knowledge in vision and ophthalmology. ARVO's headquarters are located in Rockville, Md. For more information about ARVO, logon towww.arvo.org.

The National Eye Institute (NEI) conducts and supports research that leads to sight-saving treatments and plays a key role in reducing visual impairment and blindness. The NEI is part of the National Institutes of Health (NIH), an agency of the U.S. Department of Health and Human Services. For more information, logon to http://www.nei.nih.gov.

Elinore Tibbetts
etibbetts@arvo.org
240-221-2923
Association for Research in Vision and Ophthalmology
http://www.arvo.org