Vision services in children: optimal service models and perspectives of vision specialists

What are the aims of this project?

The study aim is to conduct a scoping review of the literature and a small number of semistructured interviews (up to 20) with vision specialists and allied healthcare professionals from primary care, community and secondary care settings to investigate the barriers to vision screening and eye care among children.

Why is this important?

Research has shown that non­attendance for vision services/treatment following screening by young children is particularly high nationally and the picture is similar in the Yorkshire and Humber Region. Little is known precisely why this is the case, although a constellation of factors are likely to contribute such as the local population’s knowledge of ophthalmic conditions, perceived susceptibility and expectations of the outcome, and social and cultural factors which may act as barriers to attendance for vision treatment. Non­attendance for vision services may have detrimental outcomes on children’s educational progression, attainment and health literacy in subsequent years of development. We therefore anticipate that the in depth data obtained from the interviews with vision specialists will inform the development of a new service model that may encourage higher uptake of vision care in this young group of patients. A member of the research team will also conduct interviews with the parents/guardians/families of these children which taken together with the current interview study will provide a detailed understanding of the reasons which facilitate and inhibit the uptake of vision care services. This information will be used to design new approaches to service provision, improving access to children’s ophthalmic services; this will inform service delivery both locally and nationally. At this stage it is uncertain as to what the evidence will be and the form of the service re­design. Possibilities include revising or targeting information for certain groups, providing services in a more accessible location, such as the school itself or a more effective “one­stop shop” service in the community.

How will the research be carried out?

This research project forms a part of a current mixed method population cohort study conducted by Dr Alison Bruce's NIHR Fellowship at the University of Bradford, who is conducting a programme of research to determine the visual status of 4­5 year old children on school entry and to estimate the relationship with uptake of eye care services and emerging literacy skills. It is estimated that a large proportion of children in this age group fail to attend referrals for vision treatment on identification of eye disorders following vision screening, and it is unknown the causes of non­attendance and the most effective ways of providing vision treatment to this group of children. Dr Bruce will conduct a quantitative and qualitative (interviews with parents) study to address this question. However, the missing component that would provide a more complete understanding for non­attendance are the views of vision specialists, which we will capture using semi­structured telephone or face to face interviews. Potential participants will be identified from known vision care networks and contacts in Bradford. We will identify approximately 5 optometrists, 5 ophthalmologists, and 5 orthoptists and up to 5 other related vision care professionals for interview.


August 2015 to April 2016

Who is undertaking the research?

The research is led by Dr Tom Sanders (ScHARR). The research team also includes Dr Alison Bruce (Bradford Institute for Health Research) and Ms Viola Cassetti (Research Assistant).

How are stakeholders being engaged?

This study is a collaboration between the Universities of Sheffield, Bradford and York, and is jointly funded by the CLAHRC YH's Translation Knowledge to Action Theme and the Healthy Children and Healthy Families Theme. Local schools in Bradford are being engaged in this work as well as local vision specialists and vision/eye care charities.
The CLAHRC YH Translating Knowledge to Action Theme supports this research and provides expertise from implementation science and knowledge mobilisation to accelerate the adoption of findings into practice.
Web link: http://clahrc­­themes/translating­knowledge­into­action/meet­the­team

What will be the outputs from the study?

The findings from this research will be published in peer reviewed journals. Other outputs will include conference presentations.