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Aya Sami, Frea Sloot, Mirjana Bjeloš, Branka Stirn Kranjc, Mari Levin, Grazyna Greczka, Luc Stappaerts, Amra Nadarevic Vodencarevic, Davide Bottin, Sara McCullough, Andrea Langmann, Lotte Welinder, Veit Sturm, Huibert Jan Simonsz; Preparation for the EUSCREEN Study: gathering data on vision and hearing screening programmes in 41 European countries. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2360.
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© ARVO (1962-2015); The Authors (2016-present)
To examine the diversity in paediatric vision and hearing screening programmes in Europe, in preparation for the development of a comparative cost-effectiveness model.
A questionnaire on vision, hearing and public health screening was developed by a focus group using literature and expert opinion. Questions were structured as multiple-choice with comments in 9 domains: demography and epidemiology, administration and general background, existing screening systems, coverage and attendance, tests, follow-up and diagnosis, treatment availability, cost and benefit, adverse effects. Tests used, professionals involved, age and frequency influence cost-effectiveness. Questionnaires were sent to ophthalmologists, orthoptists, otolaryngologists and audiologists in all 41 European countries. They were selected based on their expertise and involvement in paediatric screening or they were recommended by Ministries of Health.
Representatives of 18 countries have filled out the questionnaire thus far. Vision screening content is mostly decided by the Ministry of Health or Public health organisations. Prevalences of amblyopia and strabismus at the age of 7 range between 1.4-3.5% and 1.6-5% respectively. Screening professions varied from paediatrician, ophthalmologist, nurses, general practitioner, youth doctor, orthoptist, optometrist, optician or health care assistant. Most of them receive no additional training, and when, it varies in duration and is usually not certified. Target condition was amblyopia and strabismus and refractive error. Visual acuity (VA) is measured at age 3 to 5. VA charts used are Landolt-C, Tumbling-E, Lea Hyvarinen, Snellen, Sonksen, HOTV, Cardiff, Keeler, Østerber, Allen figures, Rossano Weiss and Pigassou. At age 3 and 4, Lea Hyvarinen and Cardiff are used most, in children over 4, Tumbling-E and Snellen. Inspection, fixation and Fundus red reflex are the most used vision screening tests before the age of 3. Treatment for amblyopia and strabismus is available in all countries, but sometimes limited due to economic or capacity problems. Funding is mostly by health insurance or state.
The results revealed large differences in VA charts used, professions involved in vision screening, their training, and funding sources.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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