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. 1999 Feb;89(2):193–198. doi: 10.2105/ajph.89.2.193

Measurement of the validity of a preschool vision screening program.

B Robinson 1, W R Bobier 1, E Martin 1, L Bryant 1
PMCID: PMC1508544  PMID: 9949748

Abstract

OBJECTIVES: The validity (sensitivity and specificity) of a preschool vision screening program was measured over a 3-year period to determine how well strabismus and significant refractive errors could be detected. METHODS: Public health nurses were trained to administer tests of visual acuity, stereoacuity, and ocular alignment. Failure on any test, visual acuity of 6/9 or less, stereoacuity of less than 100 seconds of arc, or an apparent misalignment of the eyes resulted in referral to an eye care practitioner. An age-matched control was also referred. Analysis of practitioner reports used predefined study-based criteria for ocular abnormalities. RESULTS: More than 1100 children were screened each year. The annually calculated prevalence of vision problems ranged between 10.5% and 13.8%. The estimated sensitivity varied from 60.4% to 70.9% (specificity, 69.6% to 79.9%). The yield indicated that a very high percentage of children with vision problems were identified for the first time. CONCLUSIONS: The validity of this screening is comparable to that of other school screenings. The limitations are predictable. Consideration should be given to replacing visual acuity tests with a rapid, objective measure of refractive error and ocular alignment.

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Selected References

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  1. Abramov I., Hainline L., Duckman R. H. Screening infant vision with paraxial photorefraction. Optom Vis Sci. 1990 Jul;67(7):538–545. doi: 10.1097/00006324-199007000-00012. [DOI] [PubMed] [Google Scholar]
  2. Almeder L. M., Peck L. B., Howland H. C. Prevalence of anisometropia in volunteer laboratory and school screening populations. Invest Ophthalmol Vis Sci. 1990 Nov;31(11):2448–2455. [PubMed] [Google Scholar]
  3. Appelboom T. M. A history of vision screening. J Sch Health. 1985 Apr;55(4):138–141. doi: 10.1111/j.1746-1561.1985.tb04102.x. [DOI] [PubMed] [Google Scholar]
  4. Atkinson J., Anker S., Evans C., Hall R., Pimm-Smith E. Visual acuity testing of young children with the Cambridge Crowding Cards at 3 and 6 m. Acta Ophthalmol (Copenh) 1988 Oct;66(5):505–508. doi: 10.1111/j.1755-3768.1988.tb04371.x. [DOI] [PubMed] [Google Scholar]
  5. Bishop A. M. Vision screening of children: a review of methods and personnel involved within the UK. Ophthalmic Physiol Opt. 1991 Jan;11(1):3–9. [PubMed] [Google Scholar]
  6. Choi B. C. Sensitivity and specificity of a single diagnostic test in the presence of work-up bias. J Clin Epidemiol. 1992 Jun;45(6):581–586. doi: 10.1016/0895-4356(92)90129-b. [DOI] [PubMed] [Google Scholar]
  7. De Becker I., MacPherson H. J., LaRoche G. R., Braunstein J., Cottle R., McIntyre L. L., Kozousek V. Negative predictive value of a population-based preschool vision screening program. Ophthalmology. 1992 Jun;99(6):998–1003. doi: 10.1016/s0161-6420(92)31865-2. [DOI] [PubMed] [Google Scholar]
  8. Feldman W., Milner R. A., Sackett B., Gilbert S. Effects of preschool screening for vision and hearing on prevalence of vision and hearing problems 6-12 months later. Lancet. 1980 Nov 8;2(8202):1014–1016. doi: 10.1016/s0140-6736(80)92167-4. [DOI] [PubMed] [Google Scholar]
  9. Heron G., Dholakia S., Collins D. E., McLaughlan H. Stereoscopic threshold in children and adults. Am J Optom Physiol Opt. 1985 Aug;62(8):505–515. doi: 10.1097/00006324-198508000-00003. [DOI] [PubMed] [Google Scholar]
  10. Hope C., Maslin K. Random dot stereogram E in vision screening of children. Aust N Z J Ophthalmol. 1990 Aug;18(3):319–324. doi: 10.1111/j.1442-9071.1990.tb00627.x. [DOI] [PubMed] [Google Scholar]
  11. Hope C., Roulston J., Hoey C., Wong A., Clover G. Community photoscreening of six to nine month old infants for amblyopiogenic risk factors. Aust N Z J Ophthalmol. 1994 Aug;22(3):193–202. doi: 10.1111/j.1442-9071.1994.tb01716.x. [DOI] [PubMed] [Google Scholar]
  12. Howland H. C., Sayles N. Photorefractive studies of normal and handicapped infants and children. Behav Brain Res. 1983 Oct;10(1):81–85. doi: 10.1016/0166-4328(83)90153-5. [DOI] [PubMed] [Google Scholar]
  13. Hsu-Winges C., Hamer R. D., Norcia A. M., Wesemann H., Chan C. Polaroid photorefractive screening of infants. J Pediatr Ophthalmol Strabismus. 1989 Sep-Oct;26(5):254–260. doi: 10.3928/0191-3913-19890901-12. [DOI] [PubMed] [Google Scholar]
  14. Kaakinen K., Kaseva H., Kause E. R. Mass screening of children for strabismus or ametropia with two-flash photoskiascopy. Acta Ophthalmol (Copenh) 1986 Feb;64(1):105–110. doi: 10.1111/j.1755-3768.1986.tb06882.x. [DOI] [PubMed] [Google Scholar]
  15. Kaakinen K., Ranta-Kemppainen L. Screening of infants for strabismus and refractive errors with two-flash photorefraction with and without cycloplegia. Acta Ophthalmol (Copenh) 1986 Oct;64(5):578–582. doi: 10.1111/j.1755-3768.1986.tb06976.x. [DOI] [PubMed] [Google Scholar]
  16. Kennedy R. A., Sheps S. B. A comparison of photoscreening techniques for amblyogenic factors in children. Can J Ophthalmol. 1989 Oct;24(6):259–264. [PubMed] [Google Scholar]
  17. Köhler L., Stigmar G. Vision screening of four-year-old children. Acta Paediatr Scand. 1973 Jan;62(1):17–27. doi: 10.1111/j.1651-2227.1973.tb08060.x. [DOI] [PubMed] [Google Scholar]
  18. Molteno A. C., Hoare-Nairne J., Parr J. C., Simpson A., Hodgkinson I. J., O'Brien N. E., Watts S. D. The Otago photoscreener, a method for the mass screening of infants to detect squint and refractive errors. Trans Ophthalmol Soc N Z. 1983;35:43–49. [PubMed] [Google Scholar]
  19. Simons K. Preschool vision screening: rationale, methodology and outcome. Surv Ophthalmol. 1996 Jul-Aug;41(1):3–30. doi: 10.1016/s0039-6257(97)81990-x. [DOI] [PubMed] [Google Scholar]
  20. Sjöstrand J., Abrahamsson M. Risk factors in amblyopia. Eye (Lond) 1990;4(Pt 6):787–793. doi: 10.1038/eye.1990.124. [DOI] [PubMed] [Google Scholar]
  21. Stewart-Brown S. L., Brewer R. The significance of minor defects of visual acuity in school children: implications for screening and treatment. Trans Ophthalmol Soc U K. 1986;105(Pt 3):287–295. [PubMed] [Google Scholar]
  22. Wormald R. P. Preschool vision screening in Cornwall: performance indicators of community orthoptists. Arch Dis Child. 1991 Aug;66(8):917–920. doi: 10.1136/adc.66.8.917. [DOI] [PMC free article] [PubMed] [Google Scholar]

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