Comparing the effectiveness of vision screenings as part of the school entrance physical examination to comprehensive vision examinations in children ages 3 to 6: An exploratory study

Purpose: The purpose of this exploratory study was to investigate the effectiveness of vision screenings performed during school entrance physical examinations compared with comprehensive vision examinations in the state of Kentucky, which mandates comprehensive eye examinations for children, ages 3 to 6, who are entering the public school system. Methods and subjects: In this exploratory study, 1,386 children had forms submitted from 36 optometrists and 1 ophthalmologist reporting on their vision and eye problems. Vision and eye problems were defined as the presence of strabismus, amblyopia, or a refractive error requiring an optical correction, as determined by the optometrists or ophthalmologist using cycloplegic refraction. Among these 1,386 children, there were 300 diagnosed with vision problems. Results: Sixty-six children were diagnosed with a vision problem who had not previously been to an eye doctor and had received a vision screening at their school entrance physical examination. In 56 of these 66 children, the vision problem was not detected by the vision screening, according to the parents. Conclusion: The exploratory study suggests that comprehensive vision examinations may identify some vision problems that were not found in children's preschool physical examinations that included vision screenings. A larger randomized study is needed to determine the most appropriate method of timely diagnosis of vision problems in children that can be corrected with early intervention in order to ensure the vision health and well-being of children entering the public school system.