Visual Function in New Zealand Children: from Preschool to Primary School

Vision screening plays a key role in detecting childhood vision conditions. Uncorrected refractive error is the leading cause of visual impairment in children and has been associated with reduced academic performance. This thesis investigated the role of the current preschool vision screening programme in detecting vision conditions, as well as the associations of vision conditions with reading parameters, in New Zealand children. Retrospective record reviews, analysis of population level data and comparison with international gold standard vision screening protocols were used to assess the efficacy of the current preschool vision screening programme. Additionally, standard optometric clinical techniques were used to complete comprehensive eye examinations, along with assessment of reading ability and eye movement. The current preschool vision screening programme achieved high overall coverage and testability. However, a lower proportion of Māori and Pacific children and those living in high deprivation communities received vision screening and follow-up care compared with their peers. Refractive error, most commonly astigmatism (65-80% of cases), was present in up to one third of children. Up to 84% of New Zealand children with ametropia did not have appropriate correction. While the current vision screening programme was effective for detecting children with amblyopia risk factors, the addition of autorefraction significantly improved its sensitivity for detecting significant refractive error (P = 0.01). Children referred from preschool vision screening also achieved lower scores on a test of early literacy compared with children who passed vision screening (P = 0.01). Poorer near VA and stereoacuity were associated with reduced reading scores and eye movement patterns that were similar to those seen in younger and less proficient readers. Equity-based improvements are required to ensure detection and treatment of vision conditions in New Zealand children through more appropriate screening targets and protocols, and improved access to screening and follow-up eye care. In particular, children with vision conditions that may affect near visual function and reading outcomes require referral for follow-up eye care. Improving screening and access to eye care will improve equity by ensuring that all children have appropriate correction to improve their health and educational outcomes.

Name thesis:degree_name

PhD

Level thesis:degree_level

Doctoral

Discipline thesis:degree_discipline

Optometry

Grantor dc:publisher

ResearchSpace@Auckland

Year dc:date.issued

2021

Author dc:creator

• Findlay, Rebecca Winifred

Advisors dc:contributor.advisor

• Black, Joanna
• Anstice, Nicola
• Chelimo, Carol

Statement dc:rights

• Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Licence dc:rights.uri

• https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm

Handle dc:identifier.uri

https://hdl.handle.net/2292/60081

OAI identifier oai:identifier

oai:researchspace.auckland.ac.nz:2292/60081