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U. Schnorbus, T.F. Buchner, U.H. Grenzebach, H. Busse; Prevalence of Amblyogenic Findings in Preschool Children: Results of a Screening Project in Kindergarten . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4846.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: In Germany screening for ocular and visual dysfunction at preschool age is routinely performed by pediatricians. However, this established screening program is not sufficient to prevent amblyopia due to its low sensitivity. The purpose of the present study was to examine preschool children for visual and ocular abnormalities in the kindergarten. Methods: 665 children aged 3.5 to 4.5 years were examined for amblyogenic ocular findings in the kindergarten (visual acuity, binocularity, stereopsis, cover test, motility, inspection, ophthalmoscopy, non-cycloplegic automated refraction). A questionnaire about the medical history and previous examinations was given to the parents. Children with remarkable test results were referred to an ophthalmologist. Results: 25.9% of the children showed one or more abnormal parameters (23.5% reduction of visual acuity, 9.3% significant refractive errors, 4.8% strabismus, 0.6% morpholgic alterations). The reports about the ophthalmologial follow-up confirmed a defect requiring therapy in 58.4%. Refractive errors, strabismus and amblyopia were the leading causes. 67.6% of the children with defects requiring treatment had an unremarkable ocular examination during the pediatricians's screening. Conclusions: A high percentage of children at the age of 3.5 to 4.5 years had remarkable results in the screening examination. In many cases the abnormal findings were not detected during the pediatric ocular screening. Thus, amblyopia might only be diagnosed when the child is too old to benefit sufficiently from treatment. A routine preschool screening by ophthalmologists, orthoptists or appropriately trained medical assistants is recommended. The present study is supported by the Bertelsmann foundation.
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