# Strategies to Improve Adherence to Eye Care Referrals for Children following Vision Screening: A Scoping Review

## TL;DR

This review explores strategies to help children follow up on eye care referrals after vision screenings, finding that communication and logistical support are most commonly used.

## Contribution

The study synthesizes strategies to improve adherence to eye care referrals for children, highlighting gaps in evaluating their effectiveness in low-income countries.

## Key findings

- Enhanced direct communication like phone calls and mailed notifications was the most frequently reported strategy.
- Logistical support, such as transportation and pre-scheduled appointments, was also commonly used.
- Effectiveness of these strategies remains under-evaluated, particularly in low-income countries.

## Abstract

Vision screening plays a critical role in identifying potential vision disorders; however, its effectiveness is compromised when follow-up with eye care professionals is not completed. Up to 60% of children with abnormal vision screenings do not attend recommended appointments with eye care providers. This study aims to identify and synthesize the strategies to improve adherence to eye care referrals following abnormal vision screening tests.

The Joanna Briggs Institute methodology was followed to conduct the scoping review. This review is part of a broader study exploring adherence to pediatric eye care referrals. A companion scoping review focusing on social risk factors of non-adherence has been submitted separately. Searches for relevant literature were performed across bibliographic databases and gray literature from their inception to July 2023, with an updated search in November 2024. The review protocol was registered with Open Science Framework. Four reviewers screened and extracted data from the included studies. Strategies were synthesized, and themes developed.

Sixteen studies assessed strategies to overcome social risk factors. The most frequently reported strategy was enhanced direct communication such as phone calls and mailed notifications (n = 13), and logistical support, including transportation and pre-scheduled appointments (n = 9).

A variety of strategies have been implemented to improve adherence to pediatric eye care referrals, with communication and logistical support being the most common strategies used. Significant gaps, however, remain in evaluating the effectiveness of these strategies, especially in low-income countries.