National survey of paediatric vision screening programs across Canada: Identifying major gaps and call to action

OBJECTIVE: Paediatric vision screening programs identify children with ocular abnormalities who would benefit from treatment by an eye care professional. A questionnaire was conducted to assess existence and uptake of school-based vision screening programs across Canada. A supplementary questionnaire was distributed among Ontario's public health units to determine implementation of government mandated vision screening for senior kindergarten children. METHODS: Chief Medical Officers of Health for each province and territory, and Ontario's thirty-four public health units were sent a questionnaire to determine: 1) whether school-based vision screening is being implemented; 2) what age groups are screened; 3) personnel used for vision screening; 4) the type of training provided for vision screening personnel; and 5) vision screening tests performed. RESULTS: Of the thirteen provinces/territories in Canada, six perform some form of school-based vision screening. Two provinces rely solely on non-school-based programs offering eligible children an eye examination by an optometrist and three rely on ocular assessment conducted by a nurse at well-child visits. In Ontario, where since 2018 vision screening for all senior kindergarten students is government mandated, only seventeen public health jurisdictions are implementing universal vision screening programs using a variety of personnel ranging from food safety workers to optometrists. CONCLUSION: Good vision is key to physical and emotional development. There is an urgent need for a universal, evidence-based and cost-effective multidisciplinary approach to standardize paediatric vision screening across Canada and break down barriers preventing children from accessing eye care.