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M.D. Farber, C. Landau, B. Odler-Chaim; Eye Screenings for Visual Disorders for Infants in Jerusalem, Israel: 1998-1999 . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1269.
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Purpose: To present the results from a successful eye screening program for infants in Jerusalem, Israel from 1998-1999. Methods: From 1998-1999 almost 8,000 Jewish children were screened in 37 Mother and Child Health Care Centers in Jerusalem. All screenings, performed by a single ophthalmologist on undilated pupils using a two and a half plus lens, included examination of ocular movements, a cover test, and an assessment of refractive error. All children with suspected ocular disorders were referred to the Michaelson Institute where they underwent a detailed examination, including cycloplegic refraction, by a single ophthalmologist and two optometrists. In addition, a small sample of children who tested negative on the eye screening were given a complete eye examination in order to estimate the accuracy of the screening test. Myopia was defined as < -0.25 D, hypermetropia as > +4.0 D, and astigmatism of at least 1.00 D (written with a minus cylinder). Results: 7,790 infants 3-24 months of age were screened in Jerusalem. A subset of 49 children testing negative on the screening exam were given a detailed follow-up eye examination. Of these, 45 (91.8%) had no ocular pathology and the others had mild degrees of astigmatism. There were 422 infants aged 3-30 months (mean 16.7 months) seen at the Institute for a follow-up examination after screening positive: 361 (84%) were found to have some eye pathology. Myopia was found in 99 infants (23.4%), hypermetropia in 13 (3.1%), astigmatism with or without any other refractive error in 316 (74.9%), and other eye pathologies in 5 (1.2%). Only 61 (14.5%) of the children tested normal. The positive predictive value of the eye screening was 85.5% and the negative predictive value was 91.8%. The incidence of myopia in Jewish infants in Jerusalem was estimated between 1-2%, and astigmatism estimated to be about 4%. Conclusions: The program in Jerusalem has demonstrated that screening of infants for visual disorders can be performed quickly, accurately, and inexpensively. Eye screenings in infants should be recommended as a part of national childrens' preventive health care programs.
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