Exploring Barriers To Visual Screening for Canadian Immigrants in a General Primary Care Clinic: A Retrospective Chart Review.

Pre-school visual health screening (visual acuity, pupillary response, visual fields, and eye movements) is vital to detect visual disorders in children. Previous studies show the prevalence of significant eye diagnoses in children to be approximately 6.7%, highlighting the importance of early intervention to prevent permanent vision loss and support educational development. This retrospective chart review aimed to compare the completion rates of visual health screenings and iron level screenings in Canadian immigrant children (ages 2–6) in a general primary care clinic. By analyzing 113 Post Arrival Health Assessments (PAHA) from an immigrant health clinic, this study investigated whether visual screenings are under-prioritized compared to other routinely completed assessments, such as iron deficiency testing. Our study found that of 113 children who completed a PAHA between 2020 and 2024, only 26/113 (23.0%) had a complete visual screen, defined as including at minimum monocular visual acuity testing, whereas 112/113 (99.1%) had a screen for iron deficiency anemia. A statistically significant difference was found between the completion rates of visual screenings and iron deficiency anemia screening (χ² = 134.46, p < 0.001). These findings support our hypothesis that visual health screenings are significantly under-prioritized compared to other routine tests. This is likely due to cultural, language, time and social barriers. Since the completion of the study, a student-run vision clinic has screened over 150 children and connected them with community optometrists. Moving forward, the research team will continue to advocate for integrating culturally inclusive education into medical school curricula to better support the health of immigrant communities.