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Alsaqr A. Eye Care in Young Children: A Parents’ Perspective of Access and Barriers. JOVR [Internet]. 2023Apr.19 [cited 2024May2];18(2):192–201. Available from: https://knepublishing.com/index.php/JOVR/article/view/13186
https://doi.org/10.18502/jovr.v18i2.13186
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Ali Alsaqr
Ali Alsaqr
Department of Optometry, College of Applied Medical Sciences, King Saud University, Saudi Arabia
Published Date
- Apr 19, 2023
Eye Care in Young Children: A Parents’ Perspective of Access and Barriers
Abstract
Purpose: To evaluate parental perspectives of accessing eye care for children aged under seven years.
Methods: The survey was conducted during September 2020 to March 2021 using online applications and distributed to parents whose children were between the ages of three and seven years. The survey included parents’ background, their knowledge of the provision of eyecare services, and the possible barriers that existed to access eye-care services. The relationship between parents’ knowledge, barrier scores, level of parental education, and demographic or socioeconomic status was assessed using nonparametric tests.
Results: In total, 1037 questionnaires were completed. The respondents were from 50 cities across Saudi regions. The participants’ age was 39 ± 7.5 years, and 54% of them had at least one child under the age of seven (n = 564). Further, 47% had not taken their children for vision screening at reception/year one (n = 467). In addition, 65% of them were not aware of the mandatory screening program at reception/year 1; whereas, only 20% (n = 207) knew how to access eye-care services; and only 39% of the children had undergone any kind of eye or vision test. The pathways to eye care and the cost of eye services/glasses were the main limitations. The parents’ responses were significantly influenced by their demographic and socioeconomic characteristics (Kruskal Wallis, P < 0.05).
Conclusion: There was a need for enhancing parent information on how to access eye care for young children and the currently available vision screening programs. Finally, a national protocol to cover the cost of the eye exam as well as spectacle prescription shall be proposed as a mean of incentive.
Keywords:
Amblyopia, Refractive Errors, Saudi Arabia, Strabismus, Vision Disorders, Vision Screening
References
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19. Bruce A, Fairley L, Chambers B, Wright J, Sheldon TA. Impact of visual acuity on developing literacy at age 4– 5 years: A cohort-nested cross-sectional study. BMJ Open 2016;6:e010434.
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28. Bardisi WM, Bin Sadiq BM Vision screening of preschool children in Jeddah, Saudi Arabia. Saudi Med J 2002;23:445–449.
29. Mathers M, Keyes M, Wright M. A review of the evidence on the effectiveness of children’s vision screening. Child Care Health Dev 2010;36:756–780.
30. Ross EL, Stein JD. Enhancing the value of preschool vision screenings. JAMA Ophthalmol 2016;134:664–665.
31. Akuffo KO, Abdul-Kabir M, Agyei-Manu E, Tsiquaye JH, Darko CK, Addo EK, Assessment of availability, awareness and perception of stakeholders regarding preschool vision screening in kumasi, ghana: An exploratory study. PLoS One 2020;15:e0230117.
32. Donaldson L, Subramanian A, Conway ML. Eye care in young children: A parent survey exploring access and barriers. Clin Exp Optom 2018;101:521–526.
33. Ebeigbe JA, Emedike CM. Parents’ awareness and perception of children’s eye diseases in nigeria. J Optom 2017;10:104–110.
34. Alsaqr AM, Masmali AM. The awareness of amblyopia among parents in saudi arabia. Ther Adv Ophthalmol 2019;11:1–7.
35. Dirani M, Chan YH, Gazzard G, Hornbeak DM, Leo SW, Selvaraj P, et al. Prevalence of refractive error in Singaporean Chinese children: The strabismus, amblyopia, and refractive error in young Singaporean children (stars) study. Invest Ophthalmol Vis Sci 2010;51:1348–1355.
36. Balasubramaniam SM, Kumar DS, Kumaran SE, Ramani KK. Factors affecting eye care-seeking behavior of parents for their children. Optom Vis Sci 2013;90:1138–1142.
37. Ebeigbe JA. Factors influencing eye-care seeking behaviour of parents for their children in nigeria. Clin Exp Optom 2018;101:560–564.
38. Sukati VN, Moodley VR, Mashige KP. Knowledge and practices of parents about child eye health care in the public sector in Swaziland. Afr J Prim Health Care Fam Med 2018;10:e1–e13.
39. Saudi Authority of Statistics. https://www.Stats.Gov.Sa/en. February 2021 [cited February 2021 February 2021]; Available from: https://www.stats.gov.sa/en.
40. Canadian Paediatric Society. Vision screening in infants, children and youth. Paediatr Child Health 2009;14:246– 251.
41. Multi-Ethnic Pediatric Eye Disease Study Group. Prevalence of myopia and hyperopia in 6- to 72- month-old African American and hispanic children: The multi-ethnic pediatric eye disease study. Ophthalmology 2010;117:140–147.e143.
42. Tadić V, Cumberland PM, Lewando-Hundt G, Rahi JS. Do visually impaired children and their parents agree on the child’s vision-related quality of life and functional vision? Br J Ophthalmol 2017;101:244–250.
43. Sharma A, Congdon N, Patel M, Gilbert C. School-based approaches to the correction of refractive error in children. Surv Ophthalmol 2012;57:272–283.
44. Senthilkumar D, Balasubramaniam SM, Kumaran SE, Ramani KK. Parents’ awareness and perception of children’s eye diseases in Chennai, India. Optom Vis Sci 2013;90:1462–1466.
45. Vongsachang H, Friedman DS, Inns A, Kretz AM, Mukherjee MR, Callan J, et al. Parent and teacher perspectives on factors decreasing participation in school-based vision programs. Ophthalmic Epidemiol 2020;27:226–236.
46. Burnett A, Paudel P, Massie J, Kong N, Kunthea E, Thomas V, et al. Parents’ willingness to pay for children’s spectacles in Cambodia. BMJ Open Ophthalmol 2021;6:2020– 000654.
47. Kimel LS. Lack of follow-up exams after failed school vision screenings: An investigation of contributing factors. J Sch Nurs 2006;22:156–162.
48. Hartmann EE, Block SS, Wallace DK. Vision and eye health in children 36 to <72 months: Proposed data system. Optom Vis Sci 2015;92:24–30.
2. LeFort SM. The statistical versus clinical significance debate. Image J Nurs Sch 1993;25:57–62.
3. Schober P, Bossers SM, Schwarte LA. Statistical significance versus clinical importance of observed effect sizes: What do p values and confidence intervals really represent? Anesth Analg 2018;126.
4. Mariani AW, Pêgo-Fernandes PM. Statistical significance and clinical significance. Sao Paulo Med J 2014;132:71–72.
5. Page P. Beyond statistical significance: Clinical interpretation of rehabilitation research literature. Int J Sports Phys Ther 2014;9:726–736.
6. Houle TT, Stump DA. Statistical significance versus clinical significance. Semin Cardiothorac Vasc Anesth 2008;12:5– 6.
7. Cassetti V, Sanders T, Bruce A. Challenges of eye health care in children and strategies to improve treatment uptake: A qualitative study from the perspective of eye care professionals in the uk. Br Ir Orthopt J 2019;15:96– 104.
8. Williams C, Northstone K, Howard M, Harvey I, Harrad RA, Sparrow JM. Prevalence and risk factors for common vision problems in children: Data from the alspac study. Br J Ophthalmol 2008;92:959–964.
9. Bruce A, Outhwaite L. Uptake, referral and attendance: Results from an inner city school based vision screening programme. Br Ir Orthopt J 2012;10:41–45.
10. Alsaqr AM, Ibrahim G, Sharha AA, Fagehi R. Investigating the visual status of preschool children in Riyadh, Saudi Arabia. Middle East Afr J Ophthalmol 2017;24:190–194.
11. Al-Rowaily MA. Prevalence of refractive errors among preschool children at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Saudi J Ophthalmol 2010;24:45–48.
12. Jonas DE, Amick HR, Wallace IF, Feltner C, Vander Schaaf EB, Brown CL, et al. Vision screening in children aged 6 months to 5 years: Evidence report and systematic review for the us preventive services task force. JAMA 2017;318:845–858.
13. Hopkins S, Sampson GP, Hendicott P, Wood JM. Review of guidelines for children’s vision screenings. Clin Exp Optom 2013;96:443–449.
14. Bruce A, Sanders T, Sheldon TA. Qualitative study investigating the perceptions of parents of children who failed vision screening at the age of 4–5 years. BMJ Paediatr Open 2018;2:e000307.
15. Williams KM, Bertelsen G, Cumberland P, Wolfram C, Verhoeven VJ, Anastasopoulos E, et al. Increasing prevalence of myopia in Europe and the impact of education. Ophthalmology 2015;122:1489–1497.
16. Kvarnstrom G, Jakobsson P, Lennerstrand G. Visual screening of swedish children: An ophthalmological evaluation. Acta Ophthalmol Scand 2001;79:240–244.
17. Rasesemola RM, Matshoge GP, Ramukumba TS. Compliance to the integrated school health policy: Intersectoral and multisectoral collaboration. Curationis 2019;42:e1–e8.
18. Su Z, Marvin EK, Wang BQ, van Zyl T, Elia MD, Garza EN, et al. Identifying barriers to follow-up eye care for children after failed vision screening in a primary care setting. J Aapos 2013;17:385–390.
19. Bruce A, Fairley L, Chambers B, Wright J, Sheldon TA. Impact of visual acuity on developing literacy at age 4– 5 years: A cohort-nested cross-sectional study. BMJ Open 2016;6:e010434.
20. Webber AL. The functional impact of amblyopia. Clin Exp Optom 2018;101:443–450.
21. Ciner E, Schmidt P, Orel-Bixler D, Dobson V, Maguire M, Cyert L, et al. Vision screening of preschool children: Evaluating the past, looking toward the future. Optom Vis Sci 1998;75:571–584.
22. Resnikoff S, Pascolinia D, Mariott SP, Pokharel GP. Global magnitude of visual impairment caused by uncorrected refractive errors in 2004. Bull World Health Organ 2008;86:63–70.
23. Smith TST, Frick KD, Holden BA, Fricke TR, Naidoo KS. Potential lost productivity resulting from the global burden of uncorrected refractive error. Bull World Health Organ 2009;87:431–437.
24. Cotter SA, Cyert LA, Miller JM, Quinn GE, National Expert Panel to the National Center for Children’s Vision and Eye Health. Vision screening for children 36 to <72 months: Recommended practices. Optom Vis Sci 2015;92:6–16.
25. Gilbert C, Ellwein L, Group RESiCS. Prevalence and causes of functional low vision in school-age children: Results from standardized population surveys in Asia, Africa, and Latin America. Invest Ophthalmol Vis Sci 2008;49:877– 881.
26. Mema SC, McIntyre L, Musto R. Childhood vision screening in Canada: Public health evidence and practice. Can J Public Health 2012;103:40–45.
27. Committee on Practice and Ambulatory Medicine, Section on Ophthalmology, American Association of Certified Orthoptists, American Association for Pediatric Ophthalmology and Strabismus, and American Academy of Ophthalmology. Eye examination in infants, children, and young adults by pediatricians. Pediatrics 2003;111:902–907.
28. Bardisi WM, Bin Sadiq BM Vision screening of preschool children in Jeddah, Saudi Arabia. Saudi Med J 2002;23:445–449.
29. Mathers M, Keyes M, Wright M. A review of the evidence on the effectiveness of children’s vision screening. Child Care Health Dev 2010;36:756–780.
30. Ross EL, Stein JD. Enhancing the value of preschool vision screenings. JAMA Ophthalmol 2016;134:664–665.
31. Akuffo KO, Abdul-Kabir M, Agyei-Manu E, Tsiquaye JH, Darko CK, Addo EK, Assessment of availability, awareness and perception of stakeholders regarding preschool vision screening in kumasi, ghana: An exploratory study. PLoS One 2020;15:e0230117.
32. Donaldson L, Subramanian A, Conway ML. Eye care in young children: A parent survey exploring access and barriers. Clin Exp Optom 2018;101:521–526.
33. Ebeigbe JA, Emedike CM. Parents’ awareness and perception of children’s eye diseases in nigeria. J Optom 2017;10:104–110.
34. Alsaqr AM, Masmali AM. The awareness of amblyopia among parents in saudi arabia. Ther Adv Ophthalmol 2019;11:1–7.
35. Dirani M, Chan YH, Gazzard G, Hornbeak DM, Leo SW, Selvaraj P, et al. Prevalence of refractive error in Singaporean Chinese children: The strabismus, amblyopia, and refractive error in young Singaporean children (stars) study. Invest Ophthalmol Vis Sci 2010;51:1348–1355.
36. Balasubramaniam SM, Kumar DS, Kumaran SE, Ramani KK. Factors affecting eye care-seeking behavior of parents for their children. Optom Vis Sci 2013;90:1138–1142.
37. Ebeigbe JA. Factors influencing eye-care seeking behaviour of parents for their children in nigeria. Clin Exp Optom 2018;101:560–564.
38. Sukati VN, Moodley VR, Mashige KP. Knowledge and practices of parents about child eye health care in the public sector in Swaziland. Afr J Prim Health Care Fam Med 2018;10:e1–e13.
39. Saudi Authority of Statistics. https://www.Stats.Gov.Sa/en. February 2021 [cited February 2021 February 2021]; Available from: https://www.stats.gov.sa/en.
40. Canadian Paediatric Society. Vision screening in infants, children and youth. Paediatr Child Health 2009;14:246– 251.
41. Multi-Ethnic Pediatric Eye Disease Study Group. Prevalence of myopia and hyperopia in 6- to 72- month-old African American and hispanic children: The multi-ethnic pediatric eye disease study. Ophthalmology 2010;117:140–147.e143.
42. Tadić V, Cumberland PM, Lewando-Hundt G, Rahi JS. Do visually impaired children and their parents agree on the child’s vision-related quality of life and functional vision? Br J Ophthalmol 2017;101:244–250.
43. Sharma A, Congdon N, Patel M, Gilbert C. School-based approaches to the correction of refractive error in children. Surv Ophthalmol 2012;57:272–283.
44. Senthilkumar D, Balasubramaniam SM, Kumaran SE, Ramani KK. Parents’ awareness and perception of children’s eye diseases in Chennai, India. Optom Vis Sci 2013;90:1462–1466.
45. Vongsachang H, Friedman DS, Inns A, Kretz AM, Mukherjee MR, Callan J, et al. Parent and teacher perspectives on factors decreasing participation in school-based vision programs. Ophthalmic Epidemiol 2020;27:226–236.
46. Burnett A, Paudel P, Massie J, Kong N, Kunthea E, Thomas V, et al. Parents’ willingness to pay for children’s spectacles in Cambodia. BMJ Open Ophthalmol 2021;6:2020– 000654.
47. Kimel LS. Lack of follow-up exams after failed school vision screenings: An investigation of contributing factors. J Sch Nurs 2006;22:156–162.
48. Hartmann EE, Block SS, Wallace DK. Vision and eye health in children 36 to <72 months: Proposed data system. Optom Vis Sci 2015;92:24–30.