VCOM Research Day Program Book 2023

Medical Student Research Publ ic Health

04 Lynchburg Headstart Vision Screening Initiative

Savannah Monahan; Emma Brown; Kathryn Outlaw; Megan Sadler; Kayleen Melvin; Jubin Kang; Cara Jansen; Megan Herring; Sharon Olowoyo; Eleftherios Vlahos; Robyn Anderson, PhD; Olubukola Ojuola, MD Corresponding author:

Liberty University College of Osteopathic Medicine Liberty University School of Public Health

Lastly, our study will attempt to assess the barriers to accessing care faced by those referred. Methods: Local data regarding the incidence of amblyopia in children in the Lynchburg area is unavailable in published literature, even though all HeadStart programs conduct vision screening annually. We designed a vision screening study using the PlusOptix Vision Screening  device for children attending Lynchburg’s HeadStart programs at three locations. After obtaining IRB approval from Liberty University, along with Lynchburg HeadStart leadership, our team performed vision screenings for children who met the eligibility criteria and had parental informed consent. Results: Vision screening was completed for 77 out of 91 eligible children. There were 44 females and 33 males, the mean age was 3.84 years. Sixty-one of the children identified as Black/African American, 7 as White/Caucasian, and 9 did not wish to provide this information. Of those screened, 32.5% (25/77) had an abnormal result. Every child with an abnormal result was referred for further evaluation by a local pediatric ophthalmologist. The mean age of children referred for services was 3.88 years; 14 females, 11 males; 21 Black/African American, 2 White/Caucasian, and

2 did not provide their race or ethnicity. In addition to identifying abnormal vision, the PlusOptix  device provides the indication for referral. Twelve of those with abnormal screening showed astigmatism, 8 anisometropia, 6 hyperopia, 3 myopia, and 2 gaze asymmetry. The ophthalmologist will make a definitive diagnosis. Conclusion: The referral rate observed in this study is higher than the national rate of 20% in children in HeadStart programs 6 . A limitation of our study is the small sample size. Further analysis might reveal additional explanations for the difference noted.

Introduction: Amblyopia, often referred to as ‘lazy eye’, is a vision disorder with bilateral or unilateral decrease in vision caused by abnormal vision development in childhood. It is the most common cause of monocular vision loss in children and adults and can arise from many causes including refractive errors, cataracts, or strabismus. 2 Timely screening and early intervention can mitigate the complications associated with amblyopia. The US Preventive Services Task Force recommends vision screening in all children 3 to 5 years, covering the critical period (up to 8years) for developmental screening. Typically, pediatricians offer vision screening during well child visits and in the first years of schooling. Studies have shown that screening rates among children vary by race, ethnicity, and family income 3 , reflecting differential access to healthcare services. Standard vision testing includes visual acuity assessments and evaluation for strabismus, but younger children often do not cooperate, yielding false-positive results. Photoscreeners are used with young children to improve cooperation, test accuracy, and detection of amblyopia risk factors. 3 The goal of our study was to determine the burden of amblyopia in our community by providing vision-screening services to the HeadStart population in Lynchburg, VA, refer those with abnormal screening for ophthalmologic evaluation, and track their attendance.

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