Findings from an opt-in eye examination service in English special schools. Is vision screening effective for this population?

Donaldson, Lisa; Karas, Marek; O’Brien, Donna M.; Woodhouse, J. Margaret

doi:10.1371/journal.pone.0212733

Cited by 27 publications

(28 citation statements)

References 31 publications

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“…In-school vision checks (limited to measurement of distance vision in either eye) are recommended by Public Health England in the UK as a screening tool suitable for typically developing children in mainstream education settings. However, due to the increased risk of visual impairment, vision screening is not appropriate for children in special education settings [12,13] and instead comprehensive eye examinations are recommended [14].…”

Section: Introductionmentioning

confidence: 99%

In-school eyecare in special education settings has measurable benefits for children’s vision and behaviour

Black¹,

McConnell²,

McKerr³

et al. 2019

PLoS ONE

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Objectives To determine whether implementation of comprehensive in-school eyecare results in measurable benefits for children and young people in terms of visual status, classroom behaviours and how well their visual needs are met. Design School-based observational study. Participants & Methods 200 pupils [mean age 10 years 9 months, 70% male, majority moderate (40%) or severe (35%) learning difficulty] of a special education school in the UK. A sector-agreed in-school eyecare framework including full eye examination and cycloplegic refraction, dispensing of spectacles (as appropriate) and written reporting of outcomes to parents/teachers was applied. Classroom behaviours were observed and recorded prior to, and after, the in-school eyecare. Surveys were employed to obtain visual histories from parents/teachers. School records and statutory documents were reviewed for diagnostic and learning disability classifications. Visual function and ocular health were profiled at baseline and significant visual deficits identified. Where such deficits were previously unrecognised, untreated or not compensated for (e.g. correction of refractive error, enlargement of educational material) they were recorded as ‘unmet visual need’. At follow-up, 2–5 months after initial (baseline) measures, eye examinations, parent/teacher surveys and behaviour observations were repeated. Follow-up measures were used to determine if measurable improvements were evident in visual function, ocular health, the level of unmet need and classroom behaviour following implementation of in-school eyecare. Results 199 participants completed baseline and follow-up measures. 122 (61%) participants presented with at least one significant visual or ocular health deficit and 90 (45%) participants had at least one unmet visual need. Younger pupils and those with no previous history of eyecare were more likely to demonstrate unmet visual needs at baseline (OR 1.12 95% CI 1.03 to 1.21) p = 0.012; (OR 4.44 95% CI 1.38 to 14.29 p = 0.007 respectively). On follow-up, the number of pupils with unmet visual needs dropped significantly to 36 (18%) (McNemar’s test p<0.001). Visual and behavioural metrics of participants without significant visual deficits or whose visual needs were adequately addressed at baseline remained relatively unchanged between baseline and follow-up (Wilcoxon signed rank p>0.05). Where significant refractive deficits were corrected at follow-up, near visual acuity improved significantly (Wilcoxon signed rank p = 0.013), however, poor spectacle compliance was a persistent cause of unmet visual need. Off-task behaviour reduced significantly after actions to address unmet visual needs were communicated to parents and teachers (Wilcoxon signed rank p = 0.035). Conclusions The present study demonstrates for the first time measurable visual and behaviour benefits to children in special education settings w...

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Section: Introductionmentioning

confidence: 99%

In-school eyecare in special education settings has measurable benefits for children’s vision and behaviour

Black¹,

McConnell²,

McKerr³

et al. 2019

PLoS ONE

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show abstract

“…One teacher commented that the Vision Report "can impart information relating to environmental factors that can influence work/activities relating to pupils." Donaldson et al [5] report that the regular presence of eyecare professionals in special school settings allows for more effective dissemination of relevant information to teaching staff and has the added benefit of raising awareness of vision among staff [5]. In the present study, 83% of teachers valued the opportunity to speak directly to the eyecare provider regarding a child's vision, further highlighting the importance of increased communication between educators and clinicians.…”

Section: Vision Reportmentioning

confidence: 56%

“…In the present study almost one third of children required at least two visits to complete the testing procedures [13]. These 'mop up' visits fitted easily into the in-school testing schedule and is echoed in previous work [5]. The in-school setting also allowed the clinicians to collaborate with teaching staff to identify the most appropriate time to examine the child based on their behavioural and emotional needs.…”

Section: In-school Servicementioning

confidence: 62%

“…It is well established that children with developmental disability are at an increased risk of visual problems compared to their typically developing peers [ 1 – 4 ]. Despite the increased risk of visual deficits, this vulnerable group of children are often reported as having poor history of eyecare [ 5 ]. This finding indicates that barriers exist for children accessing eyecare services.…”

Section: Introductionmentioning

confidence: 99%

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Parents and teachers of children in special education settings value in-school eyecare and written reports of visual status

McConnell

Black²,

McClelland³

et al. 2020

PLoS ONE

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Objectives To evaluate parent and teacher opinion of the provision of in-school eyecare and jargon-free written reporting of visual status for children in special educational settings. Participants and methods A nationally-agreed, in-school eyecare framework for children attending special schools which recommends a full eye examination, dispensing of spectacles and provision of a jargon-free written report of visual outcomes to parents and teachers, was provided to 200 children (mean age 10 years, 9 months; 70% male) attending a special school in the UK. The written 'Vision Report' detailed, in lay-language, results from the eye examination and provided practical advice to alleviate the impact of vision difficulties both at home and in the classroom. Following implementation of the framework, parents and teachers completed a feedback questionnaire to determine their opinion of the in-school eye examination and utility of the Vision Report. Results Parents of 123 participants returned a feedback questionnaire. Eighty-eight participants were represented by the 23 teachers who returned a questionnaire. The in-school eyecare was rated positively for children in special education by 82.4% of parents and 80.9% of teachers. Key benefits included the familiarity of the in-school setting (81.3% of parents and 100% of teachers agree), the convenience of the setting for parents (74.0% of parents and 100% of teachers agree), and the opportunity for teachers to speak directly to eyecare providers regarding a child's visual needs (82.6% of teachers agree). The information provided by the Vision Report was deemed useful day-today by 78.3% of parents and 100% of

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“…Vision impairment in ID has been the topic of study in various countries, which has led to the development of initiatives such as the Opening Eyes Program [ 16 ] or the more recent SeeAbility initiative [ 17 ]. These projects promote more awareness regarding this problem as well as national mechanisms specialised in dealing with eye care in people with ID [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Visual Status in a Portuguese Population with Intellectual Disability

Serra

Costa²,

Almeida³

et al. 2020

IJERPH

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Background: Neurosensory deprivation associated with vision is a well-known fact in people with intellectual disability (ID). This work aims to report the visual status of a population with ID in Portugal. Methods: A vision screening protocol was conducted during two Special Olympics events. The vision protocol included personal medical history, ocular health evaluation, and clinical measures, such as visual acuity (VA), binocular vision, colour vision, refractive error, and intraocular pressure. This protocol was administered to 134 subjects. Results: Half of the subjects reported that they had never attended or they did not remember having attended a previous eye exam. Additionally, 10% of them had not attended an eye exam in the immediate past three years. Half the subjects failed the VA test and 13% presented moderate Visual Impairment (VI) (VA worse than 0.5 logMAR in the best eye). Manifest ocular deviation was found in 25% of the subjects and the most common ocular health dysfunction conditions were conjunctiva hyperaemia, meibomian gland dysfunction, and lens anomalies. Refractive error correction allowed a reduction in the level of moderate VI to 3.7%. Conclusions: The population analysed showed a poor eye care attendance rate and vision-related conditions are in agreement with previous reports. The development of national strategies to promote the awareness for routine eye care in people with ID and improving accessibility to eye care services may mitigate many of the most prevalent conditions encountered.

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Findings from an opt-in eye examination service in English special schools. Is vision screening effective for this population?

Cited by 27 publications

References 31 publications

In-school eyecare in special education settings has measurable benefits for children’s vision and behaviour

In-school eyecare in special education settings has measurable benefits for children’s vision and behaviour

Parents and teachers of children in special education settings value in-school eyecare and written reports of visual status

Visual Status in a Portuguese Population with Intellectual Disability

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