Eye care following pre-school vision screening: Data from the Growing Up in New Zealand study

Abstract

Aim: This study aimed to determine adherence with follow-up from the New Zealand pre-school vision screening programme. The study also examined associations between pre-school vision screening outcomes and cognitive measures assessed at the 54-month follow-up in the Growing Up in New Zealand study cohort.

Methods: A cross-sectional retrospective record review of pre-school vision screening outcomes and hospital ophthalmology records with linkage to Growing Up in New Zealand cohort study data.

Results: Of 176 children referred from vision screening, 21.6% did not attend a referral appointment. Of 138 children who attended a referral appointment, 21.0% did not attend one or more follow-up appointments. Ethnic differences were observed in attendance at referral appointments (attended Māori 13%, Pacific 22.5%, European/Other 64.5%; not attended Māori 26.3%, Pacific 28.9%, European/Other 44.7%; P = 0.04) and follow-up appointments (attended Māori 11.9%, Pacific 15.6%, European/Other 72.5%; not attended Māori 17.2%, Pacific 48.3%, European/Other 34.5%; P = 0.001). Vision screening outcome was significantly associated with letter naming fluency scores (P = 0.01) but not name and numbers scores (P = 0.05).

Conclusions: Non-attendance at referral and follow-up appointments limits the efficacy of vision screening, particularly for children of Māori and Pacific ethnicity. Children referred from vision screening achieve lower scores on letter naming fluency, a key predictor of reading ability in later childhood. Equity-based improvements are required to ensure that all children referred from vision screening receive appropriate follow-up eye care.

Keywords: child; education; ethnic groups; pre‐school; socio‐economic factors; vision screening.

Fig. 1

Flow diagram of vision screening eligibility, consent, referral and outcome for children enrolled in the Growing Up in New Zealand study and residing in the Counties Manukau District Health Board region.

Fig. 2

Attendance at referral appointments and follow‐up appointments by child ethnicity. () Māori; () Pacific; () European/Other.

Fig. 3

Attendance at referral appointments and follow‐up appointments by area‐level socio‐economic deprivation of household where child lives. () Deciles 1–3 (low); () Deciles 4–7 (moderate); () Deciles 8–10 (high).