Hidden in Plain Sight: Detecting Vision Problems in Preschoolers

E. Eugenie Hartmann, PhD, Senior Research Scientist at the Vision Center and Rebecca D. Considine Research Institute at Akron Children’s Hospital

Project Description:

Routine vision screening for children ages 3, 4, and 5 should be a standard part of pediatric care. Yet, at this age, traditional methods—like reading letters from an eye chart—are not feasible. The challenge is clear: how can we accurately determine what young children see? The answer lies in knowing how to ask the question in a developmentally appropriate way.

Using strategies grounded in Implementation Science, we have introduced photo-screening technology into all general pediatric practices affiliated with Akron Children’s Hospital (ACH). Coordinated through the Vision Center, this project follows a standardized protocol that has allowed us to build a large dataset to evaluate the effectiveness of this screening approach. Our goals are to determine:

1. Age-specific accuracy of the referral criteria.
2. Concordance of screening results with comprehensive eye care evaluations by specialists.

Monthly electronic health record reports show that approximately 3,500 children between ages 3 and 5 receive well-child care visits across ACH clinics. Of these, roughly 10% are flagged by the screening device for referral to an eye care specialist. Each practice provides us with spreadsheets summarizing screening results, which we then link to corresponding comprehensive exam findings from the Vision Center.

Moving forward, we need assistance with integrating screening data and clinical outcomes, as well as identifying barriers that limit follow-up and treatment adherence in our patient population.

Although this project does not involve direct patient interaction, it offers a valuable opportunity to gain insight into both normal and atypical visual system development in children. By contributing to this work, you will help shape the evidence base for improving pediatric vision screening practices.

Expectations:

We are looking for approximately 10 hours/week of commitment from you on this project to have the biggest possible impact. During your first semester working with us, you will complete the following:

1. Complete CITI-Training courses as determined by ACH Institutional Review Board.
2. Register as a volunteer at ACH.
3. Participate in at least some of our team’s weekly meetings to learn about the data we have.
4. Identify an area within vision screening that you are particularly interested in and complete a literature review on that topic.