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At least 19 recordsLinked to original sources
PubMed1985

A history of vision screening.

The vision screening program has a long and interesting history involving educators, pediatricians, optometrists, and ophthalmologists. Since, the earliest screening program initiated in 1899, many alterations in the original program have resulted from consideration of test reliability, testing conditions, and child maturity. Indeed, even the basic concept of vision screening had to be proven beneficial before it was widely accepted. The three basic areas of the exam - visual acuity, hyperopia, and heterophoria - developed independently into a concise, thorough screening system. Minor controversies continue, causing continuing modification and improvement.

Amblyopia↗
PubMed1977

The future of vision screening.

The future of vision screening is presently receiving heated debate. Recent federal legislative activity in the area of comprehensive health planning has caused renewed interest in vision screening. Optometric recommendations supported at various governmental levels call for the development of standards for comprehensive vision screening of school children on a national scale. This paper attempts to review the philosophy and justification for school vision screening and to bring the readers up to date on related governmental activity. The question of adequate manpower to implement a nationwide vision screening program is discussed, and an argument is developed for preparing school nurse practitioners to assume an expanded role in comprehensive vision screening.

Adolescent↗
PubMed1984

A public health perspective on vision screening.

Health screenings, including vision screenings, can be an effective means for identifying problems needing further care. This paper reviews the generally accepted criteria for determining screening protocols and discusses the concepts of sensitivity and specificity as related to vision screening.

Humans↗
PubMed1992

Negative predictive value of a population-based preschool vision screening program.

BACKGROUND: The Enhanced Vision Screening Program is a population-based vision screening program that has, at present, examined 59,782 children. Its main goal is to detect amblyopia, strabismus, and high refractive errors. An average of 11,910 4 1/2- to 5 1/2-year-old children are screened yearly. The current study determines the negative predictive value of the screening program: For a subject having passed the vision screening test, what is the probability of not having amblyopia, strabismus, or high refractive errors? METHODS: Of the 11,734 subjects who passed the vision screening, 200 were randomly chosen to undergo a strictly defined gold standard examination by an orthoptist and an ophthalmologist. RESULTS: Of the 200 randomly chosen subjects, 157 underwent the gold standard evaluation. The negative predictive value of the Enhanced Vision Screening Program was 97.6% for any potentially vision-threatening ocular condition. It was 98.7% if we considered only the visually significant ocular problems that the test was designed to detect. CONCLUSION: Because the negative predictive value of the Enhanced Vision Screening Program is not 100%, some children with amblyopia, strabismus, or refractive errors are missed. Occasionally, a rare, potentially vision-threatening condition may go undetected. Parents should be made aware of this when they receive the results of the vision screening.

Child↗
PubMed1991

Effectiveness of vision-screening in pre-school populations with preferential-looking cards used for assessment of visual acuity.

Screening the vision of pre-school populations has been suggested as a way to assure early identification of vision problems as well as early intervention, thereby enabling normal development of the visual system and learning process. In a masked investigation, 119 pre-school children enrolled in Project Headstart with a mean age of 3.51 years (range 3 to 5 years) had their vision screened using the Modified Clinical Technique (MCT). Monocular visual acuities in this population were determined using preferential-looking (PL) cards. Visual acuity assessment of young children in screening settings is at best a challenge; yet, all 119 children were able to complete monocular acuity assessments on each eye. Acuities for nonreferrals (individuals who passed the screening) were significantly better than for referrals (individuals who failed the screening) at the 0.0167 level using a two-tailed Fisher's Exact Test with the Bonferroni Method for multiple comparisons. The effectivity of the screening technique as determined by phi-coefficient remained highest (phi = +0.94) with the visual acuity referral criterion set at 6/12 (20/40) or less either eye and/or greater than or equal to a 2-octave difference between the eyes. The resultant referral rate (17.6%) was higher than that predicted by extrapolation from the Orinda Study for this age group (12.3%) but expected because of the different socioeconomic group. PL cards enabled monocular visual acuity measurement on 100% of the children tested and measurably increased the effectiveness of the screening procedure.

Child, Preschool↗
PubMed1998

Baltimore Vision Screening Project. Phase 2.

BACKGROUND: Vision screening in preschool and school age children remains a valuable method of identifying potentially treatable visual abnormalities, as well as refractive errors in the school age population. A major difficulty in conducting these types of programs is the inconsistent follow-up encountered frequently in children identified by the screening program. The Baltimore Vision Screening Project was designed to address the issue of access to care for a group of inner city elementary school students by providing on-site evaluation and treatment. METHODS: A standard vision-screening protocol was administered to prekindergarten and kindergarten students attending an inner city elementary school and access to care provided at the school. Children identified by the screening were examined at the school, and appropriate treatment was prescribed. The second phase of the study details a return to the school 1 year after the initial screening. The purpose of this was to reassess the level of visual morbidity in this population and to evaluate the effects of providing treatment in the previous year. RESULTS: Two hundred eighty-five children were screened during the 1994-1995 school year. Visual morbidity statistics from the follow-up year were similar to those of the previous screening: 5.3% diagnosed with amblyopia, 3.2% with strabismus, and 7.4% with refractive errors. Forty of the 68 children identified, examined, and treated in the previous year still were attending the school during the follow-up investigation. Compliance with recommended treatment was 30% in this group, with only 20% of the students passing the vision screening the following year. CONCLUSIONS: The follow-up screening confirmed the presence of significant visual morbidity in this group of preschool and kindergarten students. Nearly two thirds of the students had not complied with the recommended treatment or spectacle wear or both, despite providing immediate access to this care through the vision-screening program.

Baltimore↗
PubMed1991

Preschool vision screening.

Although a good case for preschool screening for vision defects can be made there is very little evidence that existing programmes are effective in practice. A comparative trial of three different methods of preschool vision screening is described. Some 7000 children initially aged 5 months (younger cohorts) and 30 months (older cohorts) in three matched areas entered the trial during 1987. During 18 months of follow up new visual and ocular defects among these children were ascertained through ophthalmology outpatients and from optician records. Screening at 35 months by an orthoptist based in the community is superior to conventional health visitor surveillance at 30 months and to an agreed programme of primary care screening for squint at 30-36 months as judged by screening sensitivity (100% v 50% v 50%) and the incidence of treated target conditions (17 v 3 v 5 per 1000 person years). A notable feature in the area served by the orthoptist is that 13 children received treatment for straight eyed visual acuity loss from among 1000 children whereas there were no such cases among 2500 in the comparison areas. In the younger cohorts (that is, screening at age 5-9 months) all three programmes showed equally poor results, only one of the eight treated target conditions arising from all 3500 younger children being screen detected.

Amblyopia↗
PubMed1996

Two infant vision screening programmes: prediction and prevention of strabismus and amblyopia from photo- and videorefractive screening.

Two infant vision screening programmes on total populations in the Cambridge Health District have been designed to identify manifest strabismus and strabismogenic and amblyogenic refractive errors at 7-9 months of age. The first, completed, programme used the isotropic photorefractor with cycloplegia together with a standard orthoptic examination. The second, current, programme uses the VRP-1 isotropic videorefractor to identify infants with accommodative lags which are followed up by refraction under cycloplegia. Both programmes show good agreement between infants identified at screening and retinoscopic refractions at follow-up, showing that photo- and videorefraction (with or without cycloplegia) can be effective methods for screening for ametropia in infants and young children. In each programme 5-6% of infants showed abnormal levels of hyperopia (> or = 3.5 D in any meridian), less than 1% showed anisometropia > or = 1.5 D; very few infants (0.25%) showed -3D myopia or greater. Less than 1% showed manifest strabismus. Hyperopic and anisometropic children entered a randomised controlled trial of partial refractive correction. All children identified at screening, alongside appropriate control groups, are extensively followed up to age 4 years. The first programme has found that children who were hyperopic in infancy were 13 times more likely to become strabismic, and 6 times more likely to show measurable acuity deficits by 4 years, compared with controls. Wearing a partial spectacle correction reduced these risk ratios to 4:1 and 2.5:1 respectively. The impaired acuity can be attributed, in part, to meridional amblyopia resulting from persisting astigmatism. Both hyperopic and myopic infants showed refractive changes in the direction of emmetropia between 9 months and 4 years. Wearing a partial spectacle correction did not affect this process of emmetropisation, but does provide the possibility of reducing the incidence of common pre-school vision problems.

Aging↗
PubMed1994

Preteaching developmentally delayed preschoolers to aid vision screening.

Early identification and treatment of vision problems is a key element in learning. For preschool children already identified with developmental delay, vision screening and visual correction are particularly essential. Participants drawn from a public Special School District were 105 preschoolers ages 3 to 5 years identified as having developmental delay. Examples included autism, Down syndrome, physical handicap, or cognitive impairment. A partnership was created between the public preschool and the University Schools of Nursing and Optometry to implement vision screening. Teachers/teacher assistants were asked to characterize the children before and after preteaching and after vision screening. Using a semantic differential scale of bipolar descriptors, planned comparisons within a repeated measures MANOVA were statistically significant for all pairs before teaching vs. the mean of after teaching/after screening (p = 0.027) but not statistically significant for after teaching vs. after vision screening (p = 1.000). Results of this preliminary study suggest preteaching could be an important part of a successful vision screening partnership in that 102 (97%) of developmentally delayed children successfully completed screening for vision problems.

Child, Preschool↗
PubMed2004

Vision health care providers' attitudes and experiences with preschool vision screening in Ontario.

PURPOSE: The validity of preschool vision screening has been questioned in the light of the World Health Organization's criteria for determining the validity of screening programs. However, recommendations toward preschool screening have been made by a number of organizations. Given the contrasting views of screening, the purpose of this study was to examine visual health care provider experiences and attitudes toward preschool screening. METHOD: Optometrists, public health administrators, pediatric ophthalmologists, and orthoptists were surveyed about opinions of, recommendations for, and experiences with preschool vision screening in Ontario. The survey focused on four areas, including general opinion of preschool screening, screening standards and practices, provider experience with preschool screening, and barriers to preschool screening. In addition, survey responses were broken down by regional access to health care. RESULTS: Overall, strong support for preschool vision screening and movement toward standardization of screening practice was found among all surveyed groups. Although support for vision screening in low health care access areas was strong, providers estimated that parent compliance to screening was weaker in low access areas. Providers also reported considerable variability in vision screening practices. In addition, although the majority of providers had been involved in a screening program, the majority was no longer involved because of lack of program organization, structure, and funding. Lack of sufficient funding, public education, organization of screening, training, and government support were listed as barriers to preschool vision screening. CONCLUSION: Providers are interested in the development of structured screening programs. However, although screening may be a way to offer some level of vision care service to low health care access areas, a number of factors need to be addressed in discussions of vision screening program standards or screening best practice. In general, preschool screening programs need to be structured, be supported, have quality control, and be evaluated.

Attitude of Health Personnel↗
PubMed1994

The effectiveness of vision screening by school nurses in secondary school.

Vision screening of 13 and 15 year old children by school nurses in Oxfordshire has declined in recent years due to the pressure of other commitments. A study was carried out to evaluate the likely consequences of failing to provide vision screening for secondary schoolchildren, in order to make a decision about the future of the service. Parents were also asked to complete a questionnaire about their children's past eye histories. Eight schools that had had no vision screening for at least three years participated in the study. Overall, 3.8% of children between 13 and 15 years old had a visual acuity of worse than 6/12 in one or both eyes, that is they failed vision screening; there was no evidence that this percentage increased significantly across this age range. Less than 1% of children were prescribed and wore spectacles as a consequence of failing vision screening and no new cases of eye pathology were detected. Questionnaire responses suggested that about 50% of children who did not wear spectacles had had an eye examination in the previous two years. The results indicate that vision screening is not the best way to meet the eye/vision needs of secondary schoolchildren. Strategies for targeting the school nursing resource more appropriately are being considered.

Adolescent↗
PubMedDate not supplied

A developmental approach to preschool vision screening.

A developmental approach to preschool vision screening is described. The choice of acuity testing material in this test is determined by the child's capabilities, assessed prior to acuity testing. When compared with the Society for Prevention of Blindness test, this approach yields approximately half the number of untestables. Further, the acuity data from the two screening tests are quite similar, and both agree well with data from an additional screening by a pediatric ophthalmologist. Screening of preschool children usually requires a number of compromises in methods felt to be ideal for adults. Sacrifices in cost (i.e., additional personnel to assist the tester), additional effort (i.e., prior training of the children), or precision of acuity measures (i.e., cruder picture type targets for all children and use of isolated targets) are typically made to assure testability. These problems have been minimized by the Experimental method. Because of its low untestability rate and its apparently valid acuity data, this developmental vision screening test can be recommended as a cost effective approach to preschool vision screening. Previous research has shown that ratings of a child's behavior during this developmentally oriented vision screening test predict results of diagnostic cognitive tests as accurately as extensive tests designed exclusively for developmental screening. This test is then extremely cost effective when used for comprehensive preschool screening.

Child, Preschool↗
PubMed1995

Vision screening of preschool children in Italy.

Vision screening of preschool children is designed and performed to identify those affected by amblyopia or related, predisposing visual defects. In order to determine the prevalence of preschool vision screening in Italy, a questionnaire was mailed to the 635 regional health offices in which the country's national health system was organized at the time of the study. Results of this survey demonstrated that in 61.3% of the regions which responded, some form of preschool vision screening is performed. However, individual, non-standardized methods are used by the physicians or health care professionals responsible in each regional program. It is evident from this study that standardized procedures for preschool vision testing are lacking in Italy, and that the existing European Community guidelines should be disseminated and applied on a greater scale for the development of such a program on the national and European level.

Amblyopia↗