@article {836926,
	title = {Results of a primary care-based quality improvement project to optimize chart-based vision screening for preschool age children.},
	journal = {J AAPOS},
	year = {2016},
	month = {2016 Jul 2},
	abstract = {PURPOSE: To design chart-based vision screening for preschool-aged children. METHODS: Our program consisted of educational sessions for providers as well as hands-on training for practice staff. We evaluated the intervention through pre- and post-intervention review of medical records. RESULTS: Completion of full vision screening (distance visual acuity in each eye plus stereovision beginning at 3 years of age, as recommended at the time of the project) at well-child visits improved for 5-year-olds (45.0\% to 58.2\%; risk difference +13.2\% [95\% CI, 1.7-24.7]) and 4-year-olds (39.3\% to 51.4\%; risk difference +12.0\% [95\% CI, 0.7-23.4]) but declined somewhat among 3-year-olds (23.1\% to 14.3\%; risk difference, -8.8\% [95\% CI, -17.7 to 0.0]). Risk factors for not being fully screened included being 3 years old (risk ratio of 4.1 compared to 5-year-olds) and being a patient of a small practice (risk ratio of 1.9 compared to large practices). CONCLUSIONS: This quality improvement project showed that screening for visual acuity and stereovision among preschool-aged children using chart-based techniques is difficult to accomplish and unlikely to be consistently successful, especially among 3-year-olds.},
	issn = {1528-3933},
	doi = {10.1016/j.jaapos.2016.04.005},
	author = {Modest, Jonathan R and Johnston, Suzanne C and Majzoub, Katherine M and Moore, Bruce and Trudell, Emily K and Ramsey, Jean E and Vernacchio, Louis}
}
