Evaluation of vision screening in five‐ to eight‐year‐old children living in Region V?stra G?taland, Sweden – a prospective multicentre study

摘要

Abstract Purpose To evaluate the current vision screening criteria regarding amblyopia and refractive errors, with emphasis on screening limits and retesting, in Region V?stra G?taland ( VGR ), Sweden. Visual acuity ( VA ) screening is performed by nurses at primary healthcare centres ( PHC s) in 4‐year‐old children and at school in 6‐ or 7‐year‐old children. Children with VA 0.65 (0.19 log MAR ) at either eye are referred. If VA is 0.65 in one or both eyes, a retest is performed by nurses at PHC s and schools, the children are then referred if VA is 0.8 (0.10 log MAR ). Methods We included all children aged ≥5 and 8?years referred between October 2014 and June 2015 from PHC s and schools to the four eye clinics in VGR , with VA ≥0.65 in one or both eyes. At the eye clinic, children underwent assessment of VA , refraction in cycloplegia, eye motility, cover test, stereo test and a slit lamp examination. Results Among the 259/295 children (139 female) participating, median age was 5.7?years (5.0–7.8?years) at referral. Glasses were prescribed due to subnormal VA with refractive errors in 20% of the children, 22% displayed heterophoria, none had heterotropia and one younger child had amblyopia. Accurate retesting gave fewer false‐positive referrals. Conclusion Our results showed that a vision screening referral cut‐off limit of VA 0.65 would leave undetected refractive errors. Residual amblyopia was uncommon. Accurate referral criteria, retesting and training of those performing the screening as well as re‐evaluation of the screening programme are all important.