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At least 793 records · Page 44Linked to original sources
PubMed1989

Screening for retinopathy of prematurity in a regional neonatal intensive care unit.

Retinopathy of prematurity (ROP) is attracting renewed interest from ophthalmologists and neonatologists because of the improved survival of very low birthweight premature infants, some of whom develop blinding disease. Ophthalmologists may find increasing pressure from paediatric colleagues to provide a screening service for babies at risk. The results of the last twenty-two months of a continuing programme at this hospital demonstrate the benefits of active screening, but indicate some of the potential problems for ophthalmologists who are likely to become involved in this work now and in the future.

Blindness↗
PubMed1998

Screening for visual and ocular disorders in children, evaluation of the system in Sweden.

The aim of this study was to evaluate the visual screening system in Sweden. We have made a retrospective investigation of the results of screening for ocular disease and visual impairment of all children born in 1982 in three Swedish communities. The records from screening examinations from 0 to 10 y and from diagnostic follow-up at the departments of ophthalmology that the children were referred to were inspected. The data were used to evaluate the efficiency of the Swedish visual screening system. The study included 3126 children. The attendance rate at the 4-y examination was better than 99%. The sensitivity of the 4- and 5.5-y screening examinations was on the average 92% and the specificity was 97%. The average number of false negative cases at 4 y was 5.6 in 1000 (0.56%). With this screening and subsequent diagnosis and treatment, the prevalence of amblyopia at different levels of visual acuity at the age of 10 y was: 0.06% with visual acuity < or = 0.1, 0.9% with visual acuity < or = 0.5 and 1.7% with visual acuity < or = 0.7. In spite of largely unchanged pressure of amblyogenic factors in the population, the prevalence of deep and moderate amblyopia has been markedly reduced by screening and early treatment.

Amblyopia↗
PubMed2006

Towards comprehensive population-based screening for diabetic retinopathy: operation of the North Wales diabetic retinopathy screening programme using a central patient register and various screening methods.

OBJECTIVES: To examine whether population-based retinopathy screening using a central diabetes register and employing various screening methods can achieve a high degree of population coverage to meet National Screening Committee (NSC) targets. To identify the main barriers to achieving comprehensive population coverage. To analyse referrals to ophthalmology and their outcome as a measure of previously unmet need. To assess the influence of modality of screening. SETTING: Three local health board areas in North Wales. METHODS: Establishment of a district diabetes register to hold records of all patients and subserve call-recall of general practitioner (GP) sole-care patients for screening by optometrists or digital photography. Hospital attenders were screened in diabetic clinic by direct ophthalmoscopy. Data were collected for years 1 and 2 of operation of the scheme. RESULTS: The system held a screening record for 86% of diabetic patients after year 1 and 93% after year 2. Failure to attend was the major barrier to comprehensive population screening, but this improved in year 2 (P<0.001). Both optometrists and photography identified substantial unmet need: 1% of all GP sole-care patients required immediate laser treatment. Photography was more sensitive than optometrist screening, but the additional retinopathy identified was mostly minor not requiring treatment. CONCLUSIONS: Lack of screening is much more important than modality of screening as a cause of missed sight-threatening retinopathy. A central, district-based patient register system identifies those patients not screened for further follow-up and can produce a high level of population coverage, close to NSC targets. Such schemes are needed, particularly to support primary care diabetes management.

Diabetic Retinopathy↗
PubMed1989

Eccentric photorefraction: improving the predictive value and yield in detection of refractive errors.

Eccentric photorefraction (EPR) is a simple photographic technique for detecting amblyopiogenic conditions. Previous EPR studies to detect refractive errors (RE) have demonstrated high sensitivity but poor predictive value. We have established new criteria for detecting RE involving quantifying retinoscopic reflex crescent widths, thereby achieving 67% predictive value with 100% sensitivity for detecting RE greater than or equal to +3.5 D in a clinical study of 69 children. Optical analysis of EPR shows that anticrescent width (light crescent-free portion of the pupil) is independent of pupil diameter. Quantifying anticrescent widths in the above clinical trial increased the predictive value to 85%. Schematic eye and human eye EPR studies verify the theoretical prediction that similar ability to detect refractive errors is maintained when the working distance and eccentricity (distance of light source from lens edge) are reduced. These improvements in EPR reduce its cost and improve its yield; both are essential for its introduction as an acceptable community screening tool.

Adolescent↗
PubMed2005

Implementation of national diabetes retinal screening programme is associated with a lower proportion of patients referred to ophthalmology.

AIMS: To examine the impact of a new national retinal screening programme on screening attendance, technical quality of images, and referrals to the ophthalmology clinic. METHODS: Results from the previous ad hoc retinal screening service were compared with data from the first year of the new Scottish Diabetes Retinal Screening Programme in Dundee, which was administered according to criteria recommended by the Health Technology Board Scotland. RESULTS: Of 5150 patients invited for screening, 10.3% of patients did not attend. Overall, 4574 patients underwent single-field digital retinal photography and 25.4% required mydriasis for an adequate image. After screening, 1.9 and 90.5% were recalled for repeat photography at 6 months and 1 year, respectively, whilst 4.6% were ungradable and 3.0% were referred to the ophthalmology clinic. Compared with the last 18 months of the previous scheme, with the new programme a smaller proportion of patients were referred to ophthalmology (3.0 vs. 5.9%; P < 0.001, difference 2.9%: 95% confidence interval 2.1-3.7%). Moreover, the attendance was higher (89 vs. 82%; P < 0.01) and there were fewer ungradable images (4.6 vs. 7.1%; P < 0.001). CONCLUSIONS: Introduction of a systematic retinal screening programme can reduce the proportion of patients referred to the ophthalmology clinic, and use ophthalmology services more efficiently.

Adult↗