Ai-Hong Chen, Nurul F Abu Bakar, Ethan TS Hoe, Cosette YW Hoe and Nathan G Congdon

Keywords: questionnaire, mass screening, eye screening, vision screening, proxy-reporting

Abstract: The primary purpose of vision screening is to detect early signs of eye diseases in order to implement an early intervention to enhance the quality of life. Accessibility to paediatric vision screening plays a significant role to prevent vision loss by identifying diseases and problems early on to reduce visual impairment and blindness in the community. Due to cost-labour-time factors, most eye care practices do not offer paediatric vision screening. We aim to introduce a new technique for the purpose of opportunistic paediatric vision screening using proxy-reporting paediatric eye screening questionnaire (PRePESQ). Working backwards technique focused on target users was engaged to obtain the minimum set of requirements. That was done through item generation from both literature review and focus group study on images as answer options to add clarity to the questionnaire conceptual model development. Multi-perspective development strategy was employed to integrate viewpoints from stakeholders in designing the new screening instrument. Minimalism notion that covers wide-ranging of vision and all-inclusive of the paediatric population are the key aspects of the design. There were three development steps: idea generation, problem-solving, and implementation. The initiation was about to improve the accessibility to the paediatric vision screening. The problem-solving approach was to empower proxy-administration of the paediatric vision screening. The idea was implemented by substituting the inconveniency of equipment-based vision screening with a questionnaire-based vision screening. Conceptual model and criteria were developed to construct the questionnaire items. PRePESQ contains four unique features: fast (less than 10 minutes administration duration); simple (a 2-tier system that comprises of screening-probing layers and integrates wording-image in answer options); wide-ranging eye screening (covering four visual clusters of physical, physiological, perceptual and ocular health); all-inclusive (a 3-in-1 compendium of three subsets including newborn-infant, toddler-preschooler and school-adolescent versions to cover broad paediatric age range). PRePESQ is recommended to be performed by nurses or clinic assistants in optometry and ophthalmology clinics with the assistance of primary caretakers as a complimentary paediatric vision screening tool adjunct to equipment-based vision screening.

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