Abstract
Purpose :
At Child Health Care Centers (CHCC) Dutch children are vision screened seven times. For the first visual acuity (VA) measurement at 36 months, we found 15.5% insufficient and 16.6% failed VA measurements with Amsterdam Picture Chart (APK) (Acta Ophthalmol, Oct 2018). We now report on Landolt-C at 45 months.
Methods :
In the OVAS study (Sloot, Acta Ophthalmol, 2015: 93: 318–321) 10806 children born between July 2011 and June 2012 comprising 8% of the Dutch birth figure, were eligible. VA was measured at 5 meters by youth health-care physicians or nurses, who receive one day eye examination training every five years. Sufficient VA is defined as 0.5 or better. If the Landolt-C fails the APK may be used with threshold 5/5 or better. Conditions during measurement of VA varied slightly per office, in lighting or distance from chart. Data was collected from electronic screening records.
Results :
Of 10806 children invited, 1368 children did not show up, 1014 showed up but had no VA measurement (710 already under orthoptic treatment). VA was measured in 8424, in 6134 children with Landolt-C (in 566 children combined with APK), in 1783 with APK only and 507 unknown. Of 3428 (40.7%) children the age at first VA measurement was known and averaged 47 months (range 41-56). Landolt-C failed in 9.5%, was insufficient in 13.2%, sufficient in 76.3%, while 1% was missing (Fig. 1). In 359 children with failed Landolt-C, APK was done at the same visit, with 308 reaching threshold. Of the children with insufficient or failed first measurement 65.8% and 70.6%, respectively, reached sufficient VA at repeat measurement.
Conclusions :
The number of insufficient measurements with Landolt-C at 45 months by youth health-care physicians or nurses in population-wide vision screening is only slightly lower than with APK pictures at 36 months. The failed number of measurements is half of that at 36 months.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.