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 Bringing a mobile optometrist to preschools also didn't increase the
number of children who ended up receiving follow-up eye exams,
researchers found.
Dr. Eugene Lowry of the University of California, San Francisco and
colleagues write in JAMA Ophthalmology that vision screening in
three- to five-year-olds allows early correction of eye problems.
Ensuring follow-up exams with eye doctors after a school-based eye
screening has been challenging, however. One possible solution is to
bring optometrists to preschools for follow-up appointments. Those
programs haven't been evaluated before now.
For the new study, the researchers used data from a vision screening
program. Between 2009 and 2012, the parents of 175 children were
told to take the child to an eye doctor for a follow-up exam. In
2012 and 2013, however, a mobile vision unit came to the schools for
follow-up exams; during this period, 204 children were eligible for
the exams.
About 60 percent of kids ended up getting follow-up exams between
2009 and 2012, while only about 55 percent got them between 2012 and
2013.
And, the researchers found, telling children and their parents to
follow up with their own doctors was more cost effective than the
mobile eye exams in 88 percent of cases.
On average, it cost $664 to diagnose one case of lazy eye between
2009 and 2012, compared to $776 per case from 2012 to 2013.
Lowry told Reuters Health about three quarters of students would
need to complete their follow-up eye exams for the mobile method to
break even in terms of costs.
"I think there are programmatic changes that could happen to
increase follow up and make it cost effective," he said.
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In an editorial, Eric Ross and Dr. Joshua Stein of the University of
Michigan in Ann Arbor suggest changes to the mobile program.
"With a few modifications to its implementation, the mobile
follow-up could prove to be an effective and economically efficient
solution to the problem of suboptimal follow-up," they write.
Specifically, they suggest schools wait until they've received a
certain number of permission slips back from parents before inviting
the mobile unit. Additionally, the mobile examinations still
required parents to be present, which may have been a barrier to
increasing follow-up rates.
Lowry said absenteeism may also play a role in low examination
rates.
"I think this study highlights some changes that would be beneficial
to make the program cost effective," he said.
SOURCE: http://bit.ly/1Nb7ZG2 and http://bit.ly/1Nb80dj JAMA
Ophthalmology, online April 14, 2016.
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