May 2005
Volume 46, Issue 13
ARVO Annual Meeting Abstract  |   May 2005
Review of Results of Pre–School Vision Screening
Author Affiliations & Notes
  • A.C. Hudson
    Ophthalmology, Vanderbilt, Nashville, TN
  • S. Donahue
    Ophthalmology, Vanderbilt, Nashville, TN
  • Footnotes
    Commercial Relationships  A.C. Hudson, None; S. Donahue, None.
  • Footnotes
    Support  Welch–Allyn, Lions Eye Charities, Lion’s Club International Foundation, RPB
Investigative Ophthalmology & Visual Science May 2005, Vol.46, 686. doi:
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      A.C. Hudson, S. Donahue; Review of Results of Pre–School Vision Screening . Invest. Ophthalmol. Vis. Sci. 2005;46(13):686.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract: : Purpose: Amblyopia is a common cause of vision loss and may be preventable by early detection and treatment of its underlining etiology. The vision in preschoolers study (VIP) recently evauluated several vision screening instruments and found that the Welch Allyn Sure Sight had the potential to be an effective screening instrument, providing that new referral criteria are incorporated into the instrument. However, the VIP study performed field testing using trained pediatric eye doctors rather than lay personnel, and the criteria proposed for referral were determined post hoc. Thus, it is unclear if the Welch Allyn Sure Sight can be effective when utilized by lay screeners and with the proposed referral criteria. We evaluated the effectiveness of the Welch Allyn Sure Sight under these conditions. Methods: Over the past 7 years, volunteers from local Lions' Clubs have screened over 140,000 preschool children in Tennessee for amblyopia and other sight–threatening conditions. The participants, 2 to 5 year old pre–schoolers, were selected and screened with the Welch Allyn Sure Sight instrument at the local day cares, Mother’s Day Out programs, and preschools through the Tennessee Lion’s Outreach Program by their standard volunteer personnel. The new VIP criteria were programmed into the Sure Sight instrument and used for referral. Referred children were evaulated by local Optometrists or Ophthalmologists and the results of the formal examination, including cycloplegic refraction, were forwarded to Vanderbilt. Failure criteria were the standard criteria for "amblyogenic factors" propsed and published by the AAPOS Vison Screening Committee. Results: We have currently screened over 1200 children in an ongoing study. Ninety–nine percent of the children have been successfully screen tested. The current referral rate averages 8.0% and the reasons for referral includes 5.3% for astigmatism,1.3% for anisometropia, 1.1% for hyperopia, and 0.3% for high myopia. Although follow up of referred children has been limited, the predictive value positive is averaging 50%, with a higher PPV for suspected hyperopia and anisometropia, and a low PPV for astigmatism. Conclusions: The Welch–Allyn Sure Site Vision Screening Instrument has a reasonable referral rate and PPV when used in the field, provided that the VIP referral criteria are used. Overreferrals are still a problem, primarily because patients referred for suspected astigmatism are often found to be normal. Further refinements of referral criteria will increase predictive value and should be investigated.

Keywords: screening for ambylopia and strabismus • refractive error development • amblyopia 

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