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Preschool Screening for Refractive Errors: Comparison of Two Non-cycloplegic Methods
1Büchner T. F., 2Schnorbus U., 2Grenzebach U. H., 2Busse H.,
1Klinik und Poliklinik für Augenheilkunde, Direktor: Prof. Dr. H. Busse, Domagkstraße 15, 48149 Münster (Münster)
2Westfälische Wilhelms-Universität Münster, Klinik und Poliklinik für Augenheilkunde (Münster)
Purpose: Refractive errors are a common cause of amblyopia. In case of an early detection and therapy a permanent reduction in visual acuity can be prevented. The purpose of the present study is to compare the effectiveness of two preschool screening strategies.
Methods: 47 children aged 3.5 to 4.5 years were examined under authentic screening conditions in their kindergartens without cycloplegia. The H-test was used to measure the visual acuity. Refraction was examined using a handheld autorefractor. The necessity of spectacle prescription was determined by objective refraction in cycloplegia. The validity of both strategies is compared.
Results: Sensitivity is high for both screening methods. Specificity and positive predictive value are lower. Both numbers are higher for automared refraction than for testing visual acuity. The high percentage of false positive results would cause many unnecessary referrals.
Conclusions: Screening by testing a single parameter (visual acuity or non-cycloplegic automated refraction) cannot be recommended due to the high rate of false positive results. Alternative strategies are discussed.
The present study is supported by the Bertelsmann foundation.