Aim: To analyse referrals from health visitors to a (secondary) orthoptic Children’s Vision Screening Clinic (CVSC) over a 5-year period, to assess whether a change in the type of testing, increase in age at testing, and also training from an orthoptist, had influenced the accuracy of testing and referrals.
Methods: Data were collected from a departmental database to include a time span from 2 years prior to the changes to 2 years after implementation of operational changes. The changes were: (i) assessment at age 4 years instead of 3 years, (ii) visual acuity (VA) testing with a linear test instead of single optotypes and (iii) health visitor training on VA assessment. The referral reason and outcome of the visit to the CVSC were documented.
Results: The results show that, over the 5-year period studied, similar proportions of children were being referred each year with the three most common vision problems. The number of false-positive referrals fell following the operational changes made in 2004, i.e., the accuracy of referrals increased: accurate (positive) referrals of children referred with reduced vision in one eye improved from 18% to 81% and those of children referred with reduced vision in both eyes increased from 35% to 75%. These differences were statistically significant.
Conclusion: Changing to a linear test at an increased age of 4 years, along with regular teaching and updates, has had a beneficial effect on the quality of the referrals to the CVSC. To comply fully with national screening guidelines, further changes are needed and the service continues to evolve.