RESUMEN
BACKGROUND: This study compares the literacy levels of patients seeking primary optometric care at the Illinois Eye Institute, located in a Chicago inner-city neighborhood, to the literacy demands of available near point cards and patient educational materials. METHODS: The revised large print Slosson Oral Reading Test was administered to 100 primary care patients 10 to 15 minutes after the instillation of mydriatic eye drops. In addition, the Flesch-Kincaid Grade Level was calculated using the Spelling and Grammar component of the Microsoft Word software package 2003 (Microsoft, Redmond, Washington) for available near point testing cards and patient education materials used in this clinic from the American Optometric Association and the National Eye Institute. RESULTS: A total of 37.4% of patients read 1 standard deviation or more below their age-expected levels. A total of 46.5% of patients read at or below an eighth-grade level. The literacy demands of the tested near point cards ranged from 2nd grade to 12th grade. The literacy demands of patient education materials ranged from 7th grade to 12th grade. CONCLUSIONS: About one third to almost one half of the 100 patients in this sample from the Illinois Eye Institute optometry clinic read below their age-expected level. Therefore, near point testing materials and patient education materials may not be written at a suitable reading level to be effective in this population. Clinicians who provide eye care for patients in inner city settings should consider communicating important information using nonwritten methods to those patients with low literacy levels.
Asunto(s)
Hospitales Especializados , Pacientes Internos/educación , Educación del Paciente como Asunto , Población Urbana/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Chicago , Evaluación Educacional , Escolaridad , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Lectura , EscrituraRESUMEN
PURPOSE: Early detection and treatment of amblyogenic conditions such as high refractive errors and anisometropia can help prevent the development of amblyopia. The traditional gold standard for the determination of refractive error in pre-school children is retinoscopy. Difficulties with retinoscopy in pre-school children have led to the development of autorefractors that can be free of operator bias and can be used by lay individuals. The Nikon Retinomax Plus handheld autorefractor has proven to be reliable for quick and accurate assessments of refractive errors in children. The Welch Allyn SureSight Vision Screener is a relatively new handheld autorefractor. The present study compares the results of measurements with the Retinomax Plus and the SureSight to the results of cycloplegic retinoscopy in pre-school children. METHODS: Thirty-five children ranging in age from 3 to 5 years old were subjects. Any subjects with strabismus, amblyopia, nystagmus, or ocular disease were excluded. Refractive error was assessed 30 min after the application of a cycloplegic spray. RESULTS: Both autorefractors showed moderate agreement with cycloplegic retinoscopy results for measurement of spherical equivalent and cylinder power. In addition, the SureSight and the Retinomax Plus sphere and cylinder results showed moderate agreement with each other. Although the mean differences of the spherical equivalents determined were minimal, the 95% confidence intervals were large, which limits the value of the data obtained from each instrument. CONCLUSIONS: Even though the Retinomax Plus and the SureSight appear to agree with each other and with the results of cycloplegic retinoscopy for determining sphere and cylinder power, interpretation of the data should be considered as screening only because the actual magnitude of sphere and cylinder may vary from the actual magnitude. These results suggest that either device may be useful only as screening tools for assessing refractive error in pre-school children.