Mandated Kindergarten Eye Examinations in a US Suburban Clinic: Is It Worth the Cost?

Noha Ekdawi, Michael A Kipp, Matthew P Kipp Wheaton Eye Clinic, Ltd., Wheaton, IL, USACorrespondence: Noha Ekdawi Email nekdawi@wheatoneye.comPurpose: The state of Illinois has required an examination by an optometrist or ophthalmologist prior to mandatory kindergarten since 2008. This requirement h...

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Autores principales:	Ekdawi NS, Kipp MA, Kipp MP
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	refractive error kindergarten cost analysis vision screening amblyopia Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/b054484712a54b2181fb25139e4c0b12
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spelling	oai:doaj.org-article:b054484712a54b2181fb25139e4c0b122021-12-02T14:51:57ZMandated Kindergarten Eye Examinations in a US Suburban Clinic: Is It Worth the Cost?1177-5483https://doaj.org/article/b054484712a54b2181fb25139e4c0b122021-03-01T00:00:00Zhttps://www.dovepress.com/mandated-kindergarten-eye-examinations-in-a-us-suburban-clinic-is-it-w-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Noha Ekdawi, Michael A Kipp, Matthew P Kipp Wheaton Eye Clinic, Ltd., Wheaton, IL, USACorrespondence: Noha Ekdawi Email nekdawi@wheatoneye.comPurpose: The state of Illinois has required an examination by an optometrist or ophthalmologist prior to mandatory kindergarten since 2008. This requirement has allowed us to gather information regarding disease prevalence in a local suburban population.Methods: A retrospective chart review was undertaken of kindergarten eye examinations performed at the Wheaton Eye Clinic between September 2008 and February 2017. Inclusion criteria included school eye examination as a reason for the visit, and a cycloplegic refraction was completed.Results: Of 3612 patient charts identified, 1085 satisfied the inclusion criteria, of which 48% were female. The average age of the patients was 5.3 years (range, 3.8 to 6.7). Historical characteristics showed 143 (13%) were premature, 28 (3%) patients were autistic and 109 (10%) were developmentally delayed. On examination, 56 (5%) had < 20/40 (WHO mild visual impairment) vision in better seeing eye, 34 (3%) had spherical equivalent refractive error in either eye > +3.50 diopters and one < − 3.00 diopters. Fifty-eight patients (5%) were diagnosed with amblyopia and 101 patients (9.3%) were given glasses. Abnormal external exam finding was found in 218 (20%) while 16 (1.5%) had an abnormal fundus finding. Thirteen percent (146/1085) had a clinically relevant diagnosis in our examinations, with a cost of $1635/diagnosis. In total, our follow-up rate was 83% (78/94).Conclusion: Our rate of treatable ocular conditions discovered via state-mandated kindergarten eye examinations is similar to large-scale screening programs. The cost per condition found with full examinations was substantially higher; however, follow-up was more consistent.Keywords: refractive error, kindergarten, cost analysis, vision screening, amblyopiaEkdawi NSKipp MAKipp MPDove Medical Pressarticlerefractive errorkindergartencost analysisvision screeningamblyopiaOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 1331-1337 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	refractive error kindergarten cost analysis vision screening amblyopia Ophthalmology RE1-994
spellingShingle	refractive error kindergarten cost analysis vision screening amblyopia Ophthalmology RE1-994 Ekdawi NS Kipp MA Kipp MP Mandated Kindergarten Eye Examinations in a US Suburban Clinic: Is It Worth the Cost?
description	Noha Ekdawi, Michael A Kipp, Matthew P Kipp Wheaton Eye Clinic, Ltd., Wheaton, IL, USACorrespondence: Noha Ekdawi Email nekdawi@wheatoneye.comPurpose: The state of Illinois has required an examination by an optometrist or ophthalmologist prior to mandatory kindergarten since 2008. This requirement has allowed us to gather information regarding disease prevalence in a local suburban population.Methods: A retrospective chart review was undertaken of kindergarten eye examinations performed at the Wheaton Eye Clinic between September 2008 and February 2017. Inclusion criteria included school eye examination as a reason for the visit, and a cycloplegic refraction was completed.Results: Of 3612 patient charts identified, 1085 satisfied the inclusion criteria, of which 48% were female. The average age of the patients was 5.3 years (range, 3.8 to 6.7). Historical characteristics showed 143 (13%) were premature, 28 (3%) patients were autistic and 109 (10%) were developmentally delayed. On examination, 56 (5%) had < 20/40 (WHO mild visual impairment) vision in better seeing eye, 34 (3%) had spherical equivalent refractive error in either eye > +3.50 diopters and one < − 3.00 diopters. Fifty-eight patients (5%) were diagnosed with amblyopia and 101 patients (9.3%) were given glasses. Abnormal external exam finding was found in 218 (20%) while 16 (1.5%) had an abnormal fundus finding. Thirteen percent (146/1085) had a clinically relevant diagnosis in our examinations, with a cost of $1635/diagnosis. In total, our follow-up rate was 83% (78/94).Conclusion: Our rate of treatable ocular conditions discovered via state-mandated kindergarten eye examinations is similar to large-scale screening programs. The cost per condition found with full examinations was substantially higher; however, follow-up was more consistent.Keywords: refractive error, kindergarten, cost analysis, vision screening, amblyopia
format	article
author	Ekdawi NS Kipp MA Kipp MP
author_facet	Ekdawi NS Kipp MA Kipp MP
author_sort	Ekdawi NS
title	Mandated Kindergarten Eye Examinations in a US Suburban Clinic: Is It Worth the Cost?
title_short	Mandated Kindergarten Eye Examinations in a US Suburban Clinic: Is It Worth the Cost?
title_full	Mandated Kindergarten Eye Examinations in a US Suburban Clinic: Is It Worth the Cost?
title_fullStr	Mandated Kindergarten Eye Examinations in a US Suburban Clinic: Is It Worth the Cost?
title_full_unstemmed	Mandated Kindergarten Eye Examinations in a US Suburban Clinic: Is It Worth the Cost?
title_sort	mandated kindergarten eye examinations in a us suburban clinic: is it worth the cost?
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/b054484712a54b2181fb25139e4c0b12
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Mandated Kindergarten Eye Examinations in a US Suburban Clinic: Is It Worth the Cost?

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