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Original article

Can orthoptically trained personnel carry out pre-school vision screening in the absence of an orthoptist?

Authors:

Lorraine North ,

Frimley Park Hospital, Frimley; TPMH, Cyprus
About Lorraine
MSc BSc (D)
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Geeta Menon

Frimley Park Hospital, Frimley; TPMH, Cyprus
About Geeta

FRCS (Ophth) Edinburgh FRCOphth

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Abstract

Aim: To determine whether alternative personnel can carry out pre-school vision screening with the support of the visiting orthoptist providing the initial training. Also to determine whether standard protocols can be followed in relation to standards of testing and referrals.

Methods: Group 1: A retrospective cross-sectional study was carried out from January 2000 to January 2002 at RAF Akrotiri, Cyprus, to determine the number of true and false positive referrals prior to training. Group 2: A retrospective cross-sectional study was then carried out to identify all the children who had been referred directly to the orthoptist since the implementation of the new programme in April 2001. Group 3: A convenience sample was then taken from the children who had been previously tested by the health visitor or school nurse during 2001 and retested blind by the orthoptist to determine the number of false negative results.

Results: Prior to the introduction of the new direct referral system both the orthoptist and the ophthalmologist saw all patients at the same appointment. Of those referred, 41% were found to be false positives. Health visitors and school nurses underwent training with the visiting orthoptist. However, despite the training more than half the number of patients referred by the health visitors still proved to be false positive referrals. A total of 54% of patients referred were found to have no abnormality when examined by the orthoptist. Of the 34 children who were retested, 8 were found to be false negatives. The positive predictive value was only 46.34% for health visitors and school nurses.

Conclusions: The results of this study support the hypothesis that there is a difference in assessment of pre-school children by a health visitor compared with an orthoptist, as shown by the percentage of both false positives and false negatives.

DOI: http://doi.org/10.22599/bioj.42
How to Cite: North, L. & Menon, G., (2011). Can orthoptically trained personnel carry out pre-school vision screening in the absence of an orthoptist? . British and Irish Orthoptic Journal . 8 , pp . 54–58 . DOI: http://doi.org/10.22599/bioj.42
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Published on 01 Aug 2011.
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