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Arne Ohlendorf, Miguel Garcia Garcia, Siegfried Wahl; Development and test of a screening program to detect uncorrected refractive errors. . Invest. Ophthalmol. Vis. Sci. 2019;60(9):5834.
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© ARVO (1962-2015); The Authors (2016-present)
Uncorrected refractive errors (URE) are of high risk for the eye health, especially in case of myopia, where excessive axial elongation is a high risk factor for the development of choroi-retinal diseases. We have developed and tested a screening program for the uncovering of URE in school children in Germany.
Pupils from the 5th, 6th and 7th grade of a local school were invited to participate in this screening program. Non-cycloplegic distance auto-refraction (NCAR) was assessed using an open-field autorefractor (WAM-5500, Grand Seiko CO. LTD., Hiroshima, Japan). During objective autorefraction, children were briefed to look on the smallest letters of a standardized acuity chart that was placed at a distance of 4m. After autorefraction, monocular uncorrected as well as corrected distance visual acuity (UCDVA, CDVA) was assessed using software-based acuity test at the same distance. In case autorefraction revealed a spherical equivalent refractive error (SE) < -0.5D, monocular uncorrected distance visual acuity visual acuity was < 0.1logMAR and visual acuity increased after correction of the SE, children were classified as myopic.
In total, 354 children were screened on 4 consecutive days, and the average test time was around 2 minutes per child. In 38 children (10%), the screening results revealed uncovered and uncorrected myopia and these children were assigned for additional examinations. Surprisingly, prevalence of distance refractive errors was very small in the total group of children (myopia: 15%, emmetropia 75%, hyperopia: 10%).
The prevalence of uncovered myopia in this cohort of school children was around ten percent, while the overall prevalence was very low compared to previously published data in Germany. Screening programs to uncover refractive errors are of high importance for future eye health and can be fast. The combination of different cut-off thresholds (SE, UCDVA, CDVA) in such screening programs can result in a high screening accuracy.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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