Impact of Vision Screening Attitudes and Practices Among Pediatricians on Ophthalmology Referrals in Florida

Abstract Introduction: In Florida, mandated school vision screening begin around the age of five. However, a joint statement in the ophthalmology community recommends that primary care providers, including pediatricians, screen for eye and vision symptoms and signs starting at birth. This suggests that pediatricians may be the first to catch signs of early vision loss and refer pediatric patients to an ophthalmologist. This study aims to understand how current vision screening attitudes and practices of pediatricians in Florida may impact ophthalmology referrals. Methods A survey with 36 questions regarding was sent to pediatricians through digital newsletters to the Florida Chapter of the American Academy of Pediatrics and pediatric departments at Florida universities. The Jonckheere-Terpstra test was used to examine whether decreased comfort performing an eye/vision screening on a child was associated with lower rates of urgent referrals to an optometrist or ophthalmologist. Results 46 responses were collected. 50% of respondents reported receiving no previous training on performing vision screening, and less than half of respondents reported feeling “somewhat comfortable” or “extremely comfortable” with performing the exam (48%). The trend between decreased comfort performing pediatric vision screening and lower rates of urgent eye care referrals was approaching significance (p = 0.0705). The majority of urgent referrals were provided by respondents who were somewhat or extremely comfortable with screening (65%). Conclusion/Relevance: While most of the surveyed pediatricians perform early childhood vision screening (78%), many report that they have never received training on performing the exam or do not feel comfortable performing them. Increased training on vision screening procedures may help improve comfort levels and preparedness regarding vision screening, which may encourage more urgent referrals to ophthalmologists from pediatric clinics.