TY - JOUR
T1 - Analysis of the current preschool vision screening in Denmark
AU - Sandfeld, Lisbeth
AU - Weihrauch, Hanne
AU - Tubaek, Gitte
N1 - � 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
PY - 2019/8
Y1 - 2019/8
N2 - PURPOSE: To analyse the current vision screening programme for children attending school with respect to identifying children with significant refractive errors.METHODS: A total of 950 children from the municipality of Roskilde, Denmark, were invited to participate in a cross-sectional study of vision screening. 447 children aged 4.5-7 years participated in the study. The children completed a vision screening and a full eye examination. The vision screening consisted of visual acuity at distance (VA), visual acuity at distance with +2.0 glasses (VA+2), visual acuity at near (VAnear) and Lang II stereotest. A LogMAR-based picture chart was used for the vision testing. Significant refractive errors were defined as hyperopia ?+3.5 D, myopia >1.0 D, astigmatism ?1.25 D and anisometropia >1.0 D.RESULTS: Using receiver operating characteristic (ROC) curves, we could compare the efficiency of VA, VA+2, VAnear, VA in combination with VA+2 and VA in combination with VAnear. Area under the curve (AUC) for VA, VA combined with VA+2 and VA combined with VAnear was 0.841, 0.857 and 0.857, respectively, that is all classified as 'very good' screening tools, whereas VA+2 and VAnear as single screening tools were classified as 'good' with AUC of 0.704 and 0.775, respectively. Using the optimal cut-off limit from the ROC curves, VA above 0.05 LogMAR as cut-off limit showed a sensitivity of 85.2% with a specificity of 74.9%. A slightly higher sensitivity could be found when combining screening tests, but with declining specificities.CONCLUSION: Visual acuity at distance with the use of LogMAR-based charts is the optimal screening tool of choice; only minor improvements can be obtained combining with other tests.
AB - PURPOSE: To analyse the current vision screening programme for children attending school with respect to identifying children with significant refractive errors.METHODS: A total of 950 children from the municipality of Roskilde, Denmark, were invited to participate in a cross-sectional study of vision screening. 447 children aged 4.5-7 years participated in the study. The children completed a vision screening and a full eye examination. The vision screening consisted of visual acuity at distance (VA), visual acuity at distance with +2.0 glasses (VA+2), visual acuity at near (VAnear) and Lang II stereotest. A LogMAR-based picture chart was used for the vision testing. Significant refractive errors were defined as hyperopia ?+3.5 D, myopia >1.0 D, astigmatism ?1.25 D and anisometropia >1.0 D.RESULTS: Using receiver operating characteristic (ROC) curves, we could compare the efficiency of VA, VA+2, VAnear, VA in combination with VA+2 and VA in combination with VAnear. Area under the curve (AUC) for VA, VA combined with VA+2 and VA combined with VAnear was 0.841, 0.857 and 0.857, respectively, that is all classified as 'very good' screening tools, whereas VA+2 and VAnear as single screening tools were classified as 'good' with AUC of 0.704 and 0.775, respectively. Using the optimal cut-off limit from the ROC curves, VA above 0.05 LogMAR as cut-off limit showed a sensitivity of 85.2% with a specificity of 74.9%. A slightly higher sensitivity could be found when combining screening tests, but with declining specificities.CONCLUSION: Visual acuity at distance with the use of LogMAR-based charts is the optimal screening tool of choice; only minor improvements can be obtained combining with other tests.
KW - Child
KW - Child, Preschool
KW - Cross-Sectional Studies
KW - Denmark/epidemiology
KW - Female
KW - Humans
KW - Incidence
KW - Male
KW - Refraction, Ocular/physiology
KW - Refractive Errors/diagnosis
KW - Retrospective Studies
KW - Vision Screening/methods
KW - Visual Acuity
U2 - 10.1111/aos.13922
DO - 10.1111/aos.13922
M3 - Article
C2 - 30218489
VL - 97
SP - 473
EP - 477
JO - Acta Ophthalmologica
JF - Acta Ophthalmologica
SN - 1755-375X
IS - 5
ER -