School-entry vision screening in the United Kingdom: practical aspects and outcomes.

Purpose: To describe and assess an orthoptist-led vision screening service for school-entry (reception class) children, and report outcomes from one healthcare trust in the UK.

Methods: A total of 3721 children (aged 4-5 years) in reception class primary school (155 state, 3 private) underwent orthoptist-conducted vision screening. Children who failed to meet the screening criteria were referred to hospital-based eye services for re-testing and final diagnosis.

Results: The screening take-up rate was 96.41%; the remaining 3.59% refused/failed to consent to screening. The screening capture rate of participating children was 99.7%. A total of 11.14% of screened children failed to meet the screening criteria and were referred elsewhere; no abnormalities were found in 14% (false referral rate) of these children. Of the referred children, 53% had refractive errors requiring glasses and 42% had squints. The estimated percentages of common visual problems in screened children were 9.15% for refractive error and 3.81% for squint.

Conclusion: An orthoptist-led, time-of-school-entry vision screening service is ideal for successful childhood vision screening and is, thus, a valuable source of information regarding the prevalence of common visual problems among children.