BACKGROUND: Equity of access to eye care in childhood remains poorly researched, and most studies report data on utilisation without any objective measure of clinical need. Participants/method: 8271 participants from the Avon Longitudinal Study of Parents and Children (ALSPAC), a longitudinal birth cohort, were seen at age 7, when they underwent a comprehensive eye examination and details of family history of eye conditions, vision problems and contact with eye-care services were obtained. RESULTS: 2931 (35.4%) children had been in contact with an eye-care specialist, and 1452 (17.6%) had received vision screening. Compared with social class I, the prevalence of eye conditions was higher in the lower groups (social class IIIM, IV, V) (OR 1.69, 95% CI 1.15 to 2.46). However, children from lower socio-economic status groups were less likely to see an eye-care specialist (OR 0.83, 95% CI 0.70 to 1.00) or to use screening services (OR 0.65, 95% CI 0.43 to 0.98). DISCUSSION/ CONCLUSION: The differences in the trends between socio-economic groups in eye conditions and utilisation of services suggest inequitable access to services. These data highlight the limitations of community-based preschool vision screening, which fails to abolish this inequity. It is important that future research explores the reasons behind these patterns. Compulsory school-entry vision screening, as recommended by the National Screening Committee and the Hall Report may redress this differential uptake of services.
BACKGROUND: Equity of access to eye care in childhood remains poorly researched, and most studies report data on utilisation without any objective measure of clinical need. Participants/method: 8271 participants from the Avon Longitudinal Study of Parents and Children (ALSPAC), a longitudinal birth cohort, were seen at age 7, when they underwent a comprehensive eye examination and details of family history of eye conditions, vision problems and contact with eye-care services were obtained. RESULTS: 2931 (35.4%) children had been in contact with an eye-care specialist, and 1452 (17.6%) had received vision screening. Compared with social class I, the prevalence of eye conditions was higher in the lower groups (social class IIIM, IV, V) (OR 1.69, 95% CI 1.15 to 2.46). However, children from lower socio-economic status groups were less likely to see an eye-care specialist (OR 0.83, 95% CI 0.70 to 1.00) or to use screening services (OR 0.65, 95% CI 0.43 to 0.98). DISCUSSION/ CONCLUSION: The differences in the trends between socio-economic groups in eye conditions and utilisation of services suggest inequitable access to services. These data highlight the limitations of community-based preschool vision screening, which fails to abolish this inequity. It is important that future research explores the reasons behind these patterns. Compulsory school-entry vision screening, as recommended by the National Screening Committee and the Hall Report may redress this differential uptake of services.
Authors: Nicole Rosenkötter; Martien C J M van Dongen; Wolfgang Hellmeier; Klaus Simon; Pieter C Dagnelie Journal: Eur J Pediatr Date: 2012-06-23 Impact factor: 3.183
Authors: Gui-shuang Ying; Maureen G Maguire; Lynn A Cyert; Elise Ciner; Graham E Quinn; Marjean Taylor Kulp; Deborah Orel-Bixler; Bruce Moore Journal: Ophthalmology Date: 2013-10-31 Impact factor: 12.079