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Protocol - Eye Patching

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Protocol Name from Source:

The Expert Review Panel has not reviewed this measure yet.

Availability:

Publicly available

Description:

A series of interviewer-administered questions to assess history of amblyopia and associated treatments including eye patching.

Protocol:

1. Was (name of child) born with any health problems (either physical or mental)?

[ ] 1 yes (specify______________)

[ ] 2 no

[ ] 8 refused

[ ] 9 don't know

2. During the past 12 months (if child less than 12 months, the child's age in months) has (name of child) appeared to have any difficulty seeing?

[ ] 1 yes

[ ] 2 no

[ ] 8 refused

[ ] 9 don't know

3. Has (name of child) ever been diagnosed with an eye problem?

[ ] 1 yes

[ ] 2 no (skip to Q4)

[ ] 8 refused

[ ] 9 don't know

3a. When was (name of child) first diagnosed as having an eye problem?

Month_______

Year_________

4. Has a doctor ever told you that (name of child) needs to wear glasses or contact lenses?

[ ] 1 yes

[ ] 2 no (skip to Q5)

[ ] 8 refused

[ ] 9 don't know

4a. When did (name of child) first begin wearing glasses or contact lenses?

Month________

Year__________

5. Has a doctor ever told you that (name of child) had amblyopia, that is, poor vision that cannot be corrected with glasses or contact lenses?

[ ] 1 yes

[ ] 2 no (skip to Q6)

[ ] 8 refused

[ ] 9 don't know

5a. When was (name of child) first diagnosed as having amblyopia?

Month______

Year________

6. Does (name of child) have strabismus that is crossed or wall eyes, where one or both eyes turn in or turn out or up or down.

[ ] 1 yes

[ ] 2 no (skip to Q7)

[ ] 8 refused

[ ] 9 don't know

6a. When was (name of child) first diagnosed as having strabismus?

Month_________

Year___________

7. Did (he/she) ever have an operation to straighten (his/her) eyes?

[ ] 1 yes

[ ] 2 no (skip to Q8)

[ ] 8 refused

[ ] 9 don't know

7a. When did (name of child) first (?) have this type of operation?

Month_________

Year__________

8. Did (he/she) ever have to wear an eye patch to improve his/her vision?

[ ] 1 yes

[ ] 2 no (skip to Q9)

[ ] 8 refused

[ ] 9 don't know

8a. When did (name of child) first start wearing an eye patch?

Month_______

Year_________

9. In general, is your child's overall health:

[ ] 1 excellent

[ ] 2 very good

[ ] 3 good

[ ] 4 fair

[ ] 5 poor

[ ] 8 refused

[ ] 9 don't know

10. At the present time, is your child's eyesight using both eyes:

[ ] 1 excellent

[ ] 2 very good

[ ] 3 good

[ ] 4 fair

[ ] 5 poor

[ ] 8 refused

[ ] 9 don't know

Personnel and Training Required

The interviewer must be trained to conduct personal interviews with individuals from the general population. The interviewer must be trained and found to be competent (i.e. tested by an expert) at the completion of personal interviews.

Equipment Needs

Either a pencil and paper or computer-assisted instrument may be used. If a computer-assisted instrument is used, computer software may be necessary to develop the instrument. The interviewer will require a laptop computer/handheld computer to administer a computer-assisted questionnaire.

Requirements

Requirement CategoryRequired
Average time of greater than 15 minutes in an unaffected individualNo
Major equipmentNo
Specialized requirements for biospecimen collectionNo
Specialized trainingNo

Mode of Administration

Self-administered

Life Stage:

Infant, Toddler, Child

Specific Instructions:

None

Research Domain Information

Release Date:

February 26, 2010

Definition

Questions to assess history of eye patching, which is used to treat amblyopia ("lazy eye").

Purpose

A variety of eye diseases in children may have life-long implications associated with visual function and ocular health. Strabismus can cause blindness due to amblyopia if not detected in early childhood. Determining those who have a personal history of the disease identifies higher risk individuals.

Selection Rationale

The selected protocols are the current ocular survey standards for assessing visual impairment and related issues such as strabismus in the pediatric population in the U.S.

Language

Cantonese Chinese, English, Mandarin Chinese, Spanish

Standards

StandardNameIDSource
Common Data Elements (CDE)Person Eyepatch History Text3007573CDE Browser
Logical Observation Identifiers Names and Codes (LOINC)Eye patching proto62689-5LOINC

Process and Review

The Expert Review Panel has not reviewed this measure yet.

Source

University of Southern California, The Multi-Ethnic Pediatric Eye Disease Study (MEPEDS), 2002-2008.

Johns Hopkins University, Baltimore Pediatric Eye Disease Study (BPEDS), 2003-2007.

Baltimore Pediatric Eye Disease Study (BPEDS) Screening Interview Question numbers: 11 (question 1), 12 (question 2), 13 (question 3), 13a (question 3a), 14 (question 4), 14a (question 4a), 15 (question 5), 15a (question 5a), 16 (question 6), 16a (question 6a), 17 (question 7), 17a (question 7a), 18 (question 8), 18a (question 8a), 19 (question 9), and 20 (question 10)

General References

Varma R, Deneen J, Cotter S, Paz SH, Azen SP, Tarczy-Hornoch K, Zhao P; Multi-Ethnic Pediatric Eye Disease Study Group. (2006). The multi-ethnic pediatric eye disease study: design and methods. Ophthalmic Epidemiol, 13(4):253-62.

Multi-ethnic Pediatric Eye Disease Study Group. (2008). Prevalence of amblyopia and strabismus in African American and Hispanic children ages 6 to 72 months the multi-ethnic pediatric eye disease study. Ophthalmology, 115(7):1229-1236.

Friedman DS, Repka MX, Katz J, Giordano L, Ibironke J, Hawse P, Tielsch JM. (2009). Prevalence of amblyopia and strabismus in white and African American children aged 6 through 71 months the Baltimore Pediatric Eye Disease Study. Ophthalmology, 116(11):2128-34.

Protocol ID:

110601

Variables:

Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX110601_Child_Health_Problem_BornPX110601010100Was (name of child) born with any health problems (either physical or mental)?4N/A
PX110601_Child_Health_Problem_Born_SpecifyPX110601010200Specify the health problem.4N/A
PX110601_Difficulty_SeeingPX110601020000During the past 12 months (if child less than 12 months, the child's age in months) has (name of child) appeared to have any difficulty seeing?4N/A
PX110601_Eye_ProblemPX110601030100Has (name of child) ever been diagnosed with an eye problem?4N/A
PX110601_Eye_Problem_MonthPX110601030201When was (name of child) first diagnosed as having an eye problem?4N/A
PX110601_Eye_Problem_YearPX110601030202When was (name of child) first diagnosed as having an eye problem?4N/A
PX110601_Need_Glasses_Contact_LensesPX110601040100Has a doctor ever told you that (name of child) needs to wear glasses or contact lenses?4N/A
PX110601_Need_Glasses_Contact_Lenses_MonthPX110601040201When did (name of child) first begin wearing glasses or contact lenses?4N/A
PX110601_Need_Glasses_Contact_Lenses_YearPX110601040202When did (name of child) first begin wearing glasses or contact lenses?4N/A
PX110601_AmblyopiaPX110601050100Has a doctor ever told you that (name of child) had amblyopia, that is, poor vision that cannot be corrected with glasses or contact lenses?4N/A
PX110601_Amblyopia_MonthPX110601050201When was (name of child) first diagnosed as having amblyopia?4N/A
PX110601_Amblyopia_YearPX110601050202When was (name of child) first diagnosed as having amblyopia?4N/A
PX110601_StrabismusPX110601060100Does (name of child) have strabismus that is crossed or wall eyes, where one or both eyes turn in or turn out or up or down?4N/A
PX110601_Strabismus_MonthPX110601060201When was (name of child) first diagnosed as having strabismus?4N/A
PX110601_Strabismus_YearPX110601060202When was (name of child) first diagnosed as having strabismus?4N/A
PX110601_Operation_Straighten_EyesPX110601070100Did (he/she) ever have an operation to straighten (his/her) eyes?4N/A
PX110601_Operation_Straighten_Eyes_MonthPX110601070201When did (name of child) first (?) have this type of operation?4N/A
PX110601_Operation_Straighten_Eyes_YearPX110601070202When did (name of child) first (?) have this type of operation?4N/A
PX110601_Eye_PatchPX110601080100Did (he/she) ever have to wear an eye patch to improve his/her vision?4N/A
PX110601_Eye_Patch_MonthPX110601080201When did (name of child) first start wearing an eye patch?4N/A
PX110601_Eye_Patch_YearPX110601080202When did (name of child) first start wearing an eye patch?4N/A
PX110601_Child_Overall_HealthPX110601090000In general, is your child's overall health:4N/A
PX110601_Child_Eyesight_Both_EyesPX110601100000At the present time, is your child's eyesight using both eyes:4N/A